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EUROPEAN SCRIPTS - SHOULD YOU DISPENSE?
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Telfast 120mg film-coated tablets
The tablets are film-coaled peach coloured tablets containing 120 mg
fexofenadine hydrochloride, equivalent to 112 mg ol fexofenadine
For reliel of symptoms associated with seasonal allergic rhinitis.
Dosage & Administration:
For Ihe treatment ol seasonal allergic rhinitis in adults and children aged
12 years and over, the recommended dose of fexofenadine hydrochloride
is 120 mg once daily before a meal The efficacy and safety of fexofenadine
hydrochloride has not been established in children under 6 years of age.
Known hypersensitivity to any ol Ihe products ingredients.
Studies in adults have shown lhal it is not necessary to adjust the dose of
fexofenadine hydrochloride in the elderly or in renally or hepalicaily
impaired patients. However, fexotenadine should be administered with
care in these special groups.
Side effects (Please refer to the Summary of Product
Characteristics for full side-effect details):
In controlled clinical trials the incidence ol commonly reported adverse
events observed with fexofenadine was similar to fhal observed with
placebo. These adverse events were headache, drowsiness, nausea,
dizziness, and sleep disorders or paroniria, such as nightmares. In rare
cases rash, hypersensitivity reactions with manifestations such as
angioedema, chesl lightness, dyspnoea, and systemic anaphylaxis have
also been reported.
Pregnancy & Lactation:
Fexofenadine is not recommended in pregnancy or lor mothers breast-
feeding their babies, due to absence of experience in this group of patienls.
Legal Category: POM
Marketing Authorisation Number: PL 04425/0157
NHS Price: Pack of 30 Tablets: £ 6.23
Further information is available from Winlhrop Pharmaceuticals,
One Onslow Street, Guildford, Surrey, GU1 4YS.
Date of Revision of Prescribing Information: April 2009
Economise without compromise
Adverse events should be reported and information about adverse event reporting can be found on www.yellowcard.qov.uk
Adverse events should also be reported to Winthrop Pharmaceutical UK Ltd as follows:- Email: email@example.com Tel. 01483 554242 Fax.:01483 554806
For further information please visit our website www. winthmp-pharma.co.uk, freephone 0800 854431 or contact Winthrop Pharmaceuticals, 1 Onslow Street, Guildford, Surrey, GU1 4YS. Fax number 01483 554831 Date of Preparation April 2009 SJW374
Have your say
Gary Paragpuri MRPharmS
020 7921 8045
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4 THERE'S BEEN
PUBLIC HEALTH -
A decade ago Tony Blair famously
promised us 'education, education,
education'. This week David Cameron
and Nick Clegg revealed their
political aspirations under the slogan
'Freedom. Fairer. Responsibility'.
In a 36-page document setting
out the government's planned
programme of action, the Cameron-
Clegg partnership promises us "era-
radical reform" and a commitment
to "turning old thinking on its head".
If it was down to creative and
inspiring language, Dave and Nick
win hands down, but it's action and
results that count, not rhetoric.
Under Labour, GPs increased their
stranglehold on primary care and
were handsomely rewarded through
their quality and outcome
framework and as they took greater
control of commissioning services.
Under the new coalition, it
appears to be more of the same.
The new health secretary talks
of devolving power to CPs and
getting them to take on greater
responsibility for commissioning
services. The difference is to give
patients a "stronger voice" through
elected people on PCT boards (p4).
Quite where all this leaves
community pharmacy - arguably the
most accessible and efficient
healthcare provider of all - is
unclear. There's been precious little
mention of pharmacy's role in long-
term conditions or public health -
actually, there's been zero mention
of pharmacy's role in any of the
government's health policy
documents. Hopefully we can put
this down to 'early days' in the new
administration - pharmacy is
perhaps not the biggest fish in the
sea to be fair.
At least the minister with
responsibility for pharmacy has been
announced and his appointment
welcomed (p4). Nonetheless, it's
imperative that community
pharmacy seizes the initiative. We
will see a new health bill, and
primary care services will see more
upheaval. But community pharmacy
has a good story to tell - it's
efficient, accessible, trusted and able
to turn ideas into practice.
There's a window of opportunity
now for pharmacy to let the powers
that be know it can help "turn old
thinking on its head" and the sector's
lead organisations need to work
quickly before it shuts.
Elizabeth Lee - the case continues
Elizabeth Lee, the locum given a
suspended two-year jail sentence
last year for a dispensing error, has
had her sentence reduced to a fine
(p4). While every pharmacist will
welcome this news, as C+D went to
press her conviction still stood and
we still await guidance from the
Crown Prosecution Service on
decriminalising dispensing errors.
One step at a time.
Gary Paragpuri, Editor
4 New pharmacy minister named
5 GPhC in fee consultation
6 Errors in prescription pricing continue
8 Boards to tackle workplace pressure
10 Where next for the APPG?
12 Product and market news
14 Xrayserand Nick Barber
17 Update: MUR case studies
Concerning diabetes and heart failure
19 Practical Approach
20 Ethical Dilemma
A prescription from Europe - should you dispense?
22 Health and wellbeing
Dealing with accidents at work
26 Platinum Design Awards
Revealed: the UK's most stylish pharmacies
Away days can do wonders for your career
© UBM Medica, Chemist + Druggist incorporating Retail Chemist, Pharmacy Update and Beauty Counter. Published Saturdays by UBM Medica, Ludgate House, 245 Blackfriars Road, London SE 1 9UY. C+D online at.
www.chemistanddruggist.co.uk. Subscriptions: With C+D Monthly pricelist £250 (UK), without pricelist £205 (UK). ROW price £365. Circulation and subscription: UBM Information Ltd, Tower House, Sovereign Park, Lathkill St,
Market Harborough, Leics. LE16 9EF Telephone: 01858 438809 Fax: 01858 434958. Refunds on cancelled subscriptions will only be provided at the publisher's discretion, unless specifically guaranteed within the terms of
subscription offer. The editorial photos used are courtesy of the suppliers whose products they feature. We are not responsible for the content of any external websites referred to in this magazine All rights reserved No part of
this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical including photocopying, recording or any information storage or retrieval system without the express prior written consent
of the publisher. The contents of Chemist+Druggist are subject to reproduction in information storage and retrieval systems. UBM Information Ltd may pass suitable reader addresses to other relevant suppliers. If you do not wish
to receive sales information from other companies please write to Emily Miles at UBM Medica Origination by ITM Publishing Services, Central House, 142 Central St, London EC1V 8AR Printed by Headley Brothers Ltd, The Invicta
Press, Queens Road, Ashford TN24 8HH. Registered at the Post Office as a Newspaper. Volume 273 No 6749
ew pharmacy minister: plans
for sector due in 'coming months 1
Earl Howe has a strong track record in the sector, say pharmacy bodies
Earl Howe: enthusiastic about
Earl Howe, a hereditary peer, has
been named as the minister
responsible for pharmacy in England
and said the sector's future will be
outlined in the "coming months".
Earl Howe will serve as
parliamentary under secretary of
state for quality, with his portfolio
including primary care, finance, NHS
commissioning reform and
medicines, pharmacy and industry.
His appointment was welcomed
by pharmacy bodies who said his
track record had proven him to be a
strong representative for the sector.
Earl Howe told C+D he believed
pharmacists would be at the
vanguard of preventative medicine
in the coming years.
He said: "I am very enthusiastic
about how pharmacy will play a
bigger role in improving the lives of
people, especially in ensuring the
safe and effective use of medicines.
"We want people to have more
control over their health and
pharmacists are vital in our focus on
PSNC chief executive Sue Sharpe
said the committee had worked with
Earl Howe on a number of issues in
recent years and was "confident that
he will be a strong advocate for
community pharmacy within the
Department of Health". He fully
recognised pharmacy's capacity to
expand the range of services it
provided, Mrs Sharpe added.
NPA director of communications
Nicola Rossi also welcomed the
appointment, describing Earl Howe's
"keen interest" in community
pharmacy as "encouraging".
Prior to joining the Department
of Health team, Earl Howe, who
inherited his title in 1984, was
opposition spokesperson for
health and social services in the
House of Lords.
In June 2009, he campaigned for
the decriminalisation of single
dispensing errors following the
conviction of Elizabeth Lee. He
said: "Does the existence of a
strict criminal liability test enhance
public safety? If the answer is no,
as I believe, then the law needs to
In the aftermath of the
general election, the
APPG needs your MP
See analysis, plO
Elizabeth Lee overturns Government unveils
jail sentence for error NHS blueprint
Elizabeth Lee has overturned the
suspended jail sentence she received
for a one-off dispensing error made
while working as a locum forTesco
The Court of Appeal ruled Ms Lee's
punishment should be reduced to
a £300 fine as C+D went to press on
However, the judges stopped
short of overturning Ms Lee's
criminal conviction for dispensing
propranolol instead of prednisolone
to an elderly cancer patient.
Ms Lee voiced mixed feelings over
the verdict. In a written statement,
she said: "I am delighted the Court of
Appeal has reduced my sentence...
however, it is a great shame the
Court of Appeal decided not to
overturn my conviction."
Ms Lee added the "tragic" events
of the past three years would stay
with her and "no doubt" the victim's
Mark Koziol, PDA chairman and
member of Ms Lee's legal team, said
the appeal's success secured an
important precedent for all
pharmacists. Speaking exclusively to
C+D outside the court in London, he
said: "If any pharmacist finds
themselves in a similar situation
then judges will be told, don't use a
Mr Koziol added that he was
disappointed that Ms Lee's
conviction was not quashed.
Ms Lee's case sparked strong
sympathy among pharmacist
colleagues and triggered an industry-
wide campaign to decriminalise
dispensing errors last year.
Ms Lee thanked supporters for
helping her through her "ordeal".
She said: "I would like to extend a
thank you to all those pharmacists
that have wished me well. I now
wish to finally put this tragic episode
behind me." MC
For more on the
overturning of Elizabeth
Lee's conviction go to:
The coalition government has
promised greater powers for GPs
and patients in an NHS policy vision
that leaves pharmacists in the dark
over future prospects.
Doctors will be free to directly
commission services on behalf of
patients under the terms of the
health bill revealed in this week's
And PCTs will be charged with
commissioning services "best
undertaken at a wider level",
according to a programme for
government also unveiled by the
But there was no mention
of pharmacy in the health bill or
the programme for government
document and pharmacy's contract
negotiator urged caution over
"There's potential for concerns,
but some of those might be
alleviated by how this all fits
together," said Alastair Buxton,
PSNC's head of NHS services. "I
don't think anybody knows the fine
detail at the moment - this has been
put together very rapidly."
Extended GP commissioning
powers would be a key worry for
pharmacy, Mr Buxton stressed.
He also predicted a culling of PCT
numbers as the government set its
sights on cutting the cost of
administration by a third.
PSNC had launched talks with the
Department of Health on
establishing pharmacy's role in
government plans already, Mr
However, discussions had been
hindered by the embryonic status of
the coalition, he said.
Other standout proposals from
the new government included
creating an independent NHS board
in charge of allocating health
resources, incentivising ways of
improving access to primary care
in disadvantaged areas and
publishing data on the performance
of NHS providers. MC
Seethe health bill and programme
for government in full at:
Get ail the latest community pharmacy news delivered to you
GPhC proposes £262 fee
Chief executive says profit 'not on the agenda' despite proposed fee rise
The General Pharmaceutical Council
(GPhC) has launched a consultation
into its fees for 2011, and defended
the proposed renewal fees despite
criticism from the RPSGB.
The proposed renewal fee is
£262 for pharmacists and £142
for pharmacy technicians. The
pharmacist fee and the professional
leadership's body's fee of £192 come
to a total of £454 - £32 more than
the current RPSGB fee of £422.
Steve Churton, president of the
RPSGB, said he was disappointed
that the GPhC had been unable to
keep the total costs of regulation
and professional leadership to
within the current combined fee
"It is true that any organisation
going through a demerger is likely to
lose some efficiency, but it is not
clear why the total regulatory
burden has increased so
substantially," he said.
But GPhC chief executive Duncan
Rudkin said the GPhC had looked at
September takeover for GPhC
Chief executive Duncan Rudkin
has defended the. news that the
GPhC will not now fully take over
the RPSGB's regulatory functions
until the end of September this
year. He told C+D: "The GPhC
has been very careful to avoid
speculation about a date so I don't
think we're talking about a delay."
Both organisations said they
were confident the September
date was "attainable" after
constructive discussions involving
the Department of Health. It had
originally been expected that the
GPhC might take over regulation
as early as January 2010. Also
RPSGB registrar Jeremy Holmes
leaves the Society in July, Mr
Rudkin will assume the role of
registrar at the Society until the
split is complete, but he confirmed
that his employment remained
with the GPhC despite the new
accountability for RPSGB
i ; 0!;
the RPSGB regulation budgets and
costs as a way of cross-checking
whether its own cost projections
were reasonable and sensible
He stressed that making a profit
was "not on the agenda at all" for
the GPhC. And he said although the
regulator was looking to build up
reserves, these were purely to enable
it to meet any spikes in costs due to
high demand or legal cases.
"What we don't want to do is to
be putting the fee up in a reactive
and unplanned way and having it yo-
yoing, which is bad for everybody in
terms of planning and continuity,"
Mr Rudkin also reassured
pharmacists that the GPhC took its
moral duty to set fees and ensure
efficiency and cost-effectiveness
"very seriously". "I recognise that
paying fees is not something we all
do with great joy but I would hope
that people will be reassured that we
will challenge ourselves, just as
others will rightly challenge us, to
continually improve the efficiency of
what we do so that we're not racking
up costs for the sake of it."
Pharmacists have until August 16
to comment on the consultation at
i ii j .
AAH fuel surcharge rise
AAH's monthly fuel surcharge will
rise to £10.75 from June 1, the
wholesaler has announced. The
group blamed a "significant
increase in the cost of fuel in
recent months". It follows an
increase in January to £6.75.
Boots Advantage Card
Boots may open its Advantage
Card scheme to other retailers, it
has been reported. A spokesperson
said the move was "a possibility
for the future, but we are unable
to comment further".
Nice has launched the first
national evidence-based guide on
the diagnosis and management of
idiopathic constipation in children.
C+D's guide to what you need to
know about the recommendations
is at www.chemistanddruggist.
Rowlands is reviewing the
business and service opportunities
in supplying mobility aids through
pharmacies after opening a
specialist mobility and nursing
store in Portsmouth. Commercial
director John D'Arcy said:
"[Mobility] is a growth area and
you have got to say, 'Where does
pharmacy fit into that?'."
Colleagues have paid tribute to
pharmacist Allen Tweedie, who
died this week after succumbing
to pancreatic cancer. Dr Tweedie
was a fellow of the RPSGB, and
was awarded the Society's Silver
Medal in 2006 for his work for the
community pharmacy sector.
Funeral arrangements and
donation suggestions are
Murrays Healthcare's "art gallery-standard" Malvern branch (above) last week
scooped the £3,000 first prize and Best Multiple Pharmacy Award at C+D's Platinum
Design Awards 2010, in association with Ceuta Healthcare. Murrays MD Duncan
Murray (right, with C+D editor Gary Paragpuri) and other representatives from
winning and highly commended pharmacies were treated to a day at Lord's,
collecting prizes in Marylebone Cricket Club's iconic media centre. See p26 for details
Get the news every day with C+D newsletters
Errors in prescription
pricing still being made
More compensation payments likely to be needed, says PSNC
.. . nidation
Boots has warned staff working at
its Market Street, Manchester,
store that they may have been
exposed to contaminated water
last Friday. The incident occurred
after engineers working in the
store accidentally introduced
antifreeze into the water supply.
Michael Cann, commercial
director at Actavis, was set to take
up his position as chairman of the
British Generic Manufacturers
Association (BGMA) at the body's
AGM as C+D went to press. Mr
Cann takes over from Kim Innes of
Teva, who will serve as vice-chair.
The number of mothers smoking
at childbirth has fallen to 14.1 per
cent, down from 14.4 per cent
compared with last year, the DH
has said. Breastfeeding rates rose
by 1 per cent compared with last
year, reaching 72.7 per cent.
Cai nbrlan Alliance
Buying group Cambrian Alliance
has appointed Duncan Heap as
business manager for Scotland.
Mr Heap would work with
members to help them maximise
profitability, the group said.
Euro script difficulties
Pharmacists must get a simpler
system for checking prescriptions
written outside the UK, a legal
firm has warned. Existing guidance
was impractical and time
consuming, said Charles Russell.
zoe. smea firstname.lastname@example.org
Pharmacies are still not being paid
correctly by NHS Prescription
Services and are likely to require
more compensation payments in the
future, PSNC has warned.
In April contractors learnt they
would be paid £1,000 to
acknowledge pricing difficulties
experienced with processing. This
payment was to cover both the
increase in pricing errors and
inconvenience caused by the
automatic CIP processing system up
until the end of March 2009.
But Sue Sharpe, PSNC chief
executive, told C+D there was "no
doubt" pricing errors had continued
in 2009-10 and that the committee
would seek additional compensation
for this. Janet Edginton, head of
pharmacy audit at PSNC, added:
"There is no doubt that CIP requires
NHS Prescription Services
recognised the failings of the CIP
system, Ms Edginton continued,
Pharmacists have been urged to
refer all men with lower urinary
tract symptoms (LUTS) to their
GPs for full reviews of their
medication rather than continuing
Speaking at the launch of Nice
guidance on the topic, consultant
urological surgeon professor
Christopher Chappie said
assessment was "crucial" to rule
out underlying causes such as
He added: "I hope that
A Buckinghamshire hospital has
been rocked by allegations of staff
having sex in the pharmacy.
The story made headlines in
national newspapers after the claims
were made by a whistleblower
involved in an employment dispute.
In documents set to go before a
judge later this year, former nursing
v— ■--:~ r : ..v..;" .v: , - ,.,,. ., ^ . . .. .. . i . .; ,.! ,.—-
C+D has previously reported on the
impact of CIP pricing errors on
"and that's why they have agreed to
make error payments". The pricing
division was also working with PSNC
to help achieve accuracy, she said.
But the error payment deal and
the inaccurate payments came
under fire from contractors. C+D
Senator and Lloydspharmacy
regional manager Graeme Betts said:
community pharmacists support
this guideline from Nice by advising
men who wish to purchase OTC
medicines for their urinary
symptoms to visit their GP or nurse
first so they can be thoroughly
The comments followed national
media criticism of pharmacists' role
in selling P medicine Flomax to
patients with benign prostatic
But Amish Patel, of Hodgson
Pharmacy in Dartford, said the
director Maggie Southcote-Want is
reported to have accused bosses at
Milton Keynes Hospital of a series of
cover-ups, including an incident
where two members of staff were
caught having intercourse in the
However, a spokesperson for the
hospital denied any wrongdoing,
"Who knows what the size of the
recent rebate should be? It's a
number which we all say 'well, OK,
we're grateful to have it', but we've
not got the clarity to tell whether it
fulfils the whole size of what we
Graham Phillips of Hertfordshire-
based Manor Pharmacy called the
situation "nothing short of a
scandal". He called for contractors
to be paid correctly and openly.
Ms Edginton agreed it was not
acceptable for contractors to have
the prescription forms they
submitted priced inaccurately. "This
is why PSNC is continuing to work
hard to drive improvements in
pricing accuracy," she added.
Contractors still have until June
30 to submit a written request for a
check of a month's prescriptions to
take place if they feel their payment
up to March 2009 were significantly
But John Evans, superintendent at
Asda pharmacy, warned requesting
such checks would be difficult for
businesses with lots of pharmacies.
guidance undervalued the role
pharmacists could play. "I don't see
why it should be an instant referral
when we can deal with things, for
example through a patient group
direction," he said. CC
Does the Nice guidance
undermine your role as
stating that the incident had been
investigated in full.
"An allegation was made
about inappropriate behaviour in
the pharmacy. There was a full
investigation which found there
was no evidence to support
the allegation," the spokesperson
Sector 'crucial' in LUTS
'Sex in pharmacy 1 scandal makes headlines
i painkiller feared by headaches
lurofen 200mg tablets (ibuprofen) provide faster and longer relief from
headaches than standard paracetamol tablets'"'
Vhy Nurofen. Be it a niggling, thumping or plain annoying
|eadache, Nurofen can bring you fast and effective relief
L going right to the source of pain. To find out more
bout how Nurofen targets headaches visit whynurofen.com
Targeted relief from pain
ssential Information for Nurofen 200 mg Tablets
ame and Active: Nurofen 200 mg Tablets contain 200mg ibuprofen
Ddications: For the symptomatic relief of mild to moderate pain, sin h as In \* 1.x Iic.UkI .1. he,
eriod pain, dental pain, neuralgia, rheumatic and muscular pain, migraine, cold and flu
'mptoms, sore throat and fever and pain of non-serious arthritic conditions,
osage and Administration: Adults, the elderly and childien ovei 12 years' Take 1 or2caplets
iken with water, up to three times a day as required. Do not exceed 6 caplets in any 24 hours.
?ave at least 4 hours between doses. Not for use by children under 1 2 years of age. Do not
se for more than 10 days, or if symptoms worsen, consult a doctor.
ontraindications: Known hypersensitivity to ibuprofen or other ingredients. Histoiy of
ronchospasm, asthma, rhinitis, or urticaria, associated with aspirin oi other non-steroidal anti-
iflammatory drugs (NSAIDs). History of, or existing gastrointestinal ulceration/perforation or
leeding, including that associated with NSAIDs, Severe hepatic failure, severe renal failure or
!vere heart failure. Concomitant NSAIDs, including COX-2 inhibitors. Last trimester of pregnancy
fecial warnings and precautions for use: SLE and mixed connective tissue disease
astrointestinal disorders and chronic inflammatory intestinal disease. Hypertension and/or
ardiac impairment. Renal impairment Hepatic dysfunction. Bronchial asthma or alleiqn disease
il bleeding, ulceration or perforation, which can be fatal has been reported with all NSAIDs
t anytime during treatment, with oi withi iui wai ning sym| itoms or a | irevii >us history ot Gl
events. Caution with concomitant medications which could increase the risk of gastrotoxicity
or bleeding, such as corticosteroids, or anticoagulants such as warfarin or anti-platelet agents
such as aspirin. Withdraw treatment if Gl bleeding or ulceration occurs Possible reversible
effects on fertility. Avoid use during the first 6 months of pregnancy if possible
Side effects: Hypersensitivity reactions including, (a) non-specific allergic reactions and
anaphylaxis, (b) respiratory tract reactivity e.g. asthma, aggravated asthma, bronchospasm,
dyspnoea, (c) various skin reactions e g pruritus, urticaria, angiodema and more rarely exfoliative
and bullous dermatoses (including epideimal necrolysis and erythema multiforme).
Gastrointestinal disturbance including: peptic ulcer, perforation or Gl haemorrhage, headache,
acute renal failure, liver disorders, haematopoietic disorders including anaemia.
MRRP (Excl.VAT): £ 2.98 (24 tablets) £ 5 49 (48 tablets) £ 9.06 (96 tablets)
Legal category: P
Product Licence Number: PL 00327/0147
Licence Holder: Crookes Healthcare Limited, Nottingham NG2 BAA
Date of Revision: April 20 1 0.
References: 1 Pearce L,etal. Practitioner 1983;227(1377):465-7. 2 Schachtel BP et al.
Journal of Clinical Pharmacology 1996,36(12) :1 120-5 3 Data on file, Reckitt Benckiser.
Ilways read the label. Nurofen 200mg tablets contain ibuprofen
For more Q&As from the RPSGB AGM see
Can we really solve the
"No, I don't
think we can as
the number of
will always rise
as well as
saturated in terms of community
pharmacy - we don't want any more
but we still complain about
Anmish Patel, Hodgson Pharmacy,
"I would not
have thought so
as there are
always going to
be the pressures
you meet customers' needs."
Kate Molyneux, Co-op Pharmacy,
I here's not muc h
good news on the horizon according
to our pessimistic respondents, with
only one in five believing the sector's
stress situation could be worked out.
■■'■'sxt week s question:
Will the new coalition government
be good for pharmacy? Vote at
National boards promise
workplace pressure help
RPSGB annual general meeting: time has come to tackle pressure
Hannah If lyirmri
All three RPSGB national boards
have promised to tackle workplace
pressures in community pharmacy.
The comments came at the
Society's annual general meeting
and followed the C+D and PDA
Union Salary Survey 2010's finding
that less than 1 per cent of
pharmacists felt the RPSGB's
campaign on the issue had fully
succeeded so far.
Lindsey Gilpin, chair of the English
board, told the AGM the time had
come for pharmacists to stop
putting up with workplace pressures.
Ms Gilpin slammed the culture,
which sees some people dispensing
950 items a day, and said: "We want
to give pharmacists the confidence
to say, 'I am not happy with this'."
Vice-chair of the Welsh board
Mair Davies agreed workforce
pressures were high on the agenda
and said the board's key priorities
ACM speakers: workplace pressures a key joint priority
were to set minimum standards for
safe practice and to reduce time-
wasting red tape.
Ms Davies added: "[Work on]
workplace pressures will be co-
ordinated across the three boards so
the sum of the whole becomes
greater than the parts."
Scottish board chair Sandra
Society seeks help on pensions
The Department of Health (DH) has
been approached for funding to help
offset the RPSGB's pension deficit,
the Society has confirmed.
The full size of the pension deficit
will be made available next year, but
the Society's £1.9 million surplus in
the last financial year dropped to
just £39,000 after adjusting for
Director of finance Graham
Duncan confirmed the Society had
approached the DH on the matter.
He added: "I, the chief executive
and the treasurer, together with the
trustees, will continue to provide
additional funding to the pension
fund as part of the demerger."
Mr Duncan said the Society was
confident that its business plan for
the next three years provided a
financially viable organisation, but
admitted conditions for subsidiary
businesses remained difficult HF
Melville added that the future
professional body would champion
pharmacists on their behalf.
"We need a professional body to
keep in touch with live everyday
issues and to address them," she
said, highlighting issues including
supply shortages and workplace
at the AGM
Q How many staff members do
the boards have and what do the
A There are 15 employees
supporting the boards and the
total cost of supporting the
boards in 2009 was £2.7 million.
More questions online at
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In our fast moving profession, it is crucial to keep abreast of new developments.
Membership of the new Society will enable you to do just that.
We'll support you to provide the best for your patients, and in meeting the CPD requirements of
the new regulator. And we'll also be there to help you develop further if you wish to specialise in a
new area or take on new services.
We're working collaboratively with the profession to put in place the support frameworks and
assessments which mean your development will be recognised, allowing you to achieve
professional excellence and reach your full potential.
We're right behind you - helping you to develop, helping the profession to develop.
Find out more at www.rpharms.com/membership
Royal Pharmaceutical Society
The APPG: what next for
pharmacy in Parliament?
The all-party pharmacy group lost key members in the election, but
vice-chair Baroness Cumberlege tells Zoe Smeaton all is far from lost
The all-party pharmacy group
(APPG) has long been a key and
influential player in pharmacy
lobbying, helping to secure major
victories for the sector such as the
publication of the pharmacy white
paper, which the group had
pressured the government to deliver.
Baroness Cumberlege says the
group has also been instrumental in
shaping NHS policy within which
pharmacists operate. And she adds:
"Perhaps most importantly, we have
achieved a huge amount of
consensus among the main political
parties in Parliament on key issues
relating to health policy and the part
that the pharmacy profession should
play in the NHS. There are few other
policy areas, in health or elsewhere,
where such a degree of consensus
exists - even in these times of
coalition and collaboration."
The job now must be to maintain
this pace, the vice-chair says, to
ensure pharmacy's voice continues
to he heard in the new political
landscape. To make this happen
newly elected and re-elected MPs
must join the APPG and a new
leadership team must be assembled.
Baroness Cumberlege says
Baronness Cumberlege: Pharmacists
should contact their MPs and urge
them to join the APPG
progress is being made on these, but
admits that finding someone with
the commitment, expertise and
energy of former chair Dr Howard
Stoate will not be an easy task.
However, she has some words of
reassurance: "I am in contact with a
number of my parliamentary
colleagues and I am confident we
will build another strong team
during the summer. It will inevitably
take some time, but we are on top of
In a message to C+D readers, the
vice-chair asks that pharmacists help
her by contacting their local MPs.
Being enthusiastic about pharmacy
and asking them to join the group
could make all the difference. "The
general election has ushered in
hundreds of new MPs. Some have an
understanding and interest in
pharmacy, some are less familiar
with the profession and its services,"
she says. "But it is vitally important
that as many MPs as possible hear
not just from me and the group's
secretariat about joining the APPG
They also need to hear from
pharmacists in their constituencies.
If you contact them and ask them to
join the group, they are more likely
to do so. A request from a constituent
can have a telling effect. All you need
to do is send them a short email."
Doing so could just help the group
continue to facilitate debate and
discussion with policymakers and
politicians, and ultimately to press
"The APPG has had a very
positive influence on behalf of
pharmacy and the new chair will
have a hard act to follow in
Howard Stoate. But we need
local lobbying too so it's really
important for pharmacists to
talk to their MPs to ensure they
have a good understanding of
what pharmacy has to offer and
how it can help to balance
budgets in these difficult
Alastair Buxton, PSNC head of
"We have a fantastic opportunity
with the pharmacy white paper
and a lot of that was due to the
APPG. I think it's absolutely
crucial that pharmacists now get
involved and talk to new MPs,
and I don't mean whingeing-
we need to make a good
impression on them."
Graham Phillips, Hertfordshire-
based Manor Pharmacy
for improvements such as better
rewards for quality and outcomes in
pharmacy, a greater focus on
tackling adherence and waste, and
stronger local commissioning.
For more advice on how to
contact your MP you can contact
the group's secretariat (via
www.appg.org.uk) or contact C+D
(email@example.com) to help
arrange for your MP to visit your
pharmacy. To find your local MP
enter your postcode at
What key priorities do you want to see the APPG lobby on?
Number the boxes in the order that you would like to see the APPG lobby on and return the form to us:
Decriminalising dispensing errors Ql Improving medicines waste and adherence
J .iock shortages _J Securing sustainable funding for quality outcomes
□ Raising public awareness ©f pharmacy services L_) Other (please state)
Pharmacy name and address:
Daytime phone number:
Post this completed page to: C+D, 8th Floor, Ludgate House, 245 Blackf riars Road, London SE1 9U Y, fax it to 020 9721 8132 or
email your views to firstname.lastname@example.org
professionals. Our emails may also include information from other carefully selected
companies including promotional materials from pharmaceutical companies that may be of Q Please tick this box if you are happy for UBM Medica to share your details with carefully
interest to you. Your details WILL NOT be passed on to third parties without your consent. If selected third companies that wish to provide you with information about products and
you do not wish to receive information from UBM Medica, please tick this box Q services for healthcare professionals.
Chemist Druggist 29.05.10
Try out C+D's clinical quiz at:
Clinical debate C+D's Chris Chapman looks at the evidence behind the headlines
MMR: the stampede that cost us the herd
If you ever doubt how much
impact a single research paper can
have, think about Andrew
Wakefield's 1998 paper in the
Lancet linking MMR and autism.
The disgraced doctor was found
guilty by the CMC of serious
professional misconduct last week
over the MMR-autism issue. The
devastating repercussions of the
infamous (and now retracted) paper
are still being felt by pharmacists.
Dr Wakefield's paper looked at
12 children with developmental
disorders who had been referred to a
gastroenterology unit. In eight of the
children, onset of behavioural
symptoms was associated, by the
parents, with the MMR vaccine. At
a press conference Dr Wakefield
urged the use of single vaccines at
The press picked up on the story
and worried parents heard about it.
Dr Wakefield's calls started a
stampede and immunisation levels
began to drop.
In the decade that followed,
researchers launched a thousand
rebuttals. The evidence base is now
overwhelming in its verdict. Perhaps
most importantly, a Cochrane review
of 139 articles to assess the jab in
children found "no credible
evidence" of a link between the jab
and either autism or Crohn's disease.
But the damage had already been
done, as the authors concluded: "The
lack of confidence in MMR has caused
great damage to public health."
This is confirmed by the stats.
Measles is highly infectious, and
requires immunisation levels of
around 90 per cent for herd immunity
to be achieved. If vaccination hits 95
per cent, measles, mumps and
rubella are wiped out. This has been
accomplished in Finland.
But in England the MMR
immunisation rate for children
reaching their second birthday
stands at around 85 per cent. While
this has recovered from its lowest
ebb - around 80 per cent in 2003-04
- it pales in comparison to the more
than 91 per cent of children receiving
the jab before the Wakefield paper.
The result is pharmacists are once
again faced with diseases that had
been going the way of the dodo. In
1998 there were 56 cases of measles
in England and Wales - by 2009 there
were 1,144. It's similar for mumps -
121 cases in 1998, 7,628 in 2009.
The evidence speaks for itself. The
MMR-autism link is unfounded.
The UK has lost herd immunity to
diseases the public were once
shielded from. If we are to stop the
resurgence of these potentially fatal
conditions, we need to follow the
lead of our Scandinavian colleagues
and encourage parents who ask to
ensure their child is protected.
As the profession rapidly moves
towards being a key player in
vaccinations - with community
pharmacies vaccinating people
against everything from hepatitis
to seasonal flu - the importance of
pharmacists' effort cannot be
To discuss this subject in private
with your pharmacy colleagues,
join the debate in C+D's Linkedln
group at www.linkedin.com -
search for Chemist and Druggist.
Chat with Chris on Twitter:
The sums are simple
The more you spend the more
you save And the discounts
start from the very first pound.
That's how to buy generics
Regenovex set for
£1 million campaign
Jointcare range Regenovex will be
the focus of a television advertising
campaign later this year.
The range, launched by Deep Heat
manufacturer Mentholatum at the
beginning of this month, will be
supported by a £1 million package
that also includes trade and
consumer PR, advertising, sampling
Regenovex is the subject of
ongoing scientific research at a UK
university, to be presented at
healthcare conferences this year, and
further research is planned for later
in 2010, including a trial in the US.
The range includes one-a-day
• An estimated nine to 1 1
million people in the UK live
with arthritis (www.arthritis
• The jointcare market is
worth £83.3 million
(IRI, October 2008).
capsules "for daily joint health"
and two topical products - a gel
and a 12-hour patch - "to target
Zantac 75 web game is viral
Ceuta Healthcare has
launched a 'viral' web game
and indigestion remedy
The game can be accessed
at www.zantac.co.uk from
the end of May, part of a
£1 million multimedia
campaign for the brand.
Potential players will be
targeted via an email
campaign, press advertising and PR
Using the brand's "defuse your
food" strapline, players will be able
to look at the effect of different
foods on digestion, and pharmacy
assistants will have access to an
educational variation of the game.
Zantac advertising will appear in
women's nationals and urban
YOUR FOOD BEFORE
commuter magazines until the end
of June, and new PoS material is
Price: £7.49/24 tablets
Tel: 01202 780558
Magicool on TV for summer
Magicool and Magicool Plus will be
supported by a television campaign
from the beginning of June.
The frequency of TV spots will be
06-00143A5cl I "Ii Pfizer Limited 2009 All riqhts reserved I Date of preparation: Julv 2009
9 S| i
increased during hot spells, says
brand owner FranceMed Pharma,
and the campaign will run until
Magicool products are patented
self-chilled sprays, and the Plus
sub-range is available as Magicool
Plus Prickly Heat and Magicool Plus
The range is free from steroids anc
antihistamines, the company says.
Prices: from £3.99
Pip codes: See C+D Monthly Price
List or www.cddata.co.uk
Tel: 0208 645 0773
Sanatogen High Protein
Powder from Power Health
was briefly unavailable in the UK but
following the change of rights it is
now available to order again.
The product is a high protein
power that can be added to food.
Bayer Consumer Care took over
the Sanatogen range when it
acquired Roche Consumer
Health in early 2005, and will
continue to hold the trademark
for Sanatogen High Protein
Pip code: 315-5363
Tel: 01759 302595
Check out what's on TV
Need to train a dispensary assistant? Benchmark is your solution
Rat iopharm launches nail fungus treatment
Ratiopharm UK has launched an
OTC treatment for fungal nail
infection. ClearFeet AF Nail Fungus
Treatment is a "unique bio-active
fungal blocker" in a brush-on
applicator, according to the company.
It will be supported by "an
extensive PR campaign" focusing on
women's magazines, Ratiopharm
says, and a website will educate
consumers about the condition
The treatment is available in
three-pack shelf-ready units, and
shelf edges and consumer leaflets
will be available for display in
pharmacy stockists from next month
ClearFeet was developed by Serrix
Pip code: 354-4632
Tel: 02392 386199
• Fungal nail infection (FNI) is the most
prevalent foot problem.
• Up to three million people in the UK have FNI.
• FNI is most common in people aged 18-65.
• More men than women suffer from FNI.
Source: Mycoses, British Journal of Dermatology
atiopharm head of OTC Rob Hall explains ClearFeet's retail opportunities
How big is the fungal nail
infection (FNI) market?
Fungal toenail infection is a common
problem; some three million people
are affected in the UK and this figure
is probably much higher as most
sufferers fail to treat. Pharmacies
need to encourage more people to
treat and there is huge category
potential here. The UK OTC fungal
nail infection market is currently
worth £5.65 million a year (IRI);
however, the athlete's foot market
is worth £20. 3m (IRI), even
though FNI is more common than
athlete's foot. And only 600,000
prescriptions for FNI treatment are
dispensed per annum (INS), so the
potential for effective OTC products
Is the fungal nail infection
The ageing population is seeing an
increase in FNI and its links to
diabetes and poor circulation.
ClearFeet AF Nail Fungus Treatment
is suitable for diabetes sufferers.
Why should pharmacies
ClearFeet AF Nail Fungus Treatment
will give pharmacists 30 per cent
profit on return.
What opportunities are
there for link sales?
from athlete's foot are estimated to
How do you plan to develop
the footcare market?
Up to 30 per cent of people suffering
We are keen to develop the footcare
category, creating innovative
product solutions that offer sufferers
real, proven treatment benefits and
pharmacists great business
opportunities. The launch of a
ClearFeet athlete's foot treatment is
planned for next year.
To find out more call 0800 731 0370
or email accumulatorQ/actavis co uk
You're busy, with better things
to do than spend all day shopping
around for deals and organising
training. You've got a business to run,
so why not leave the legwork to us ?
That's how to buy generics
How to buy generics
What do you think?
A time of change? Here's my wish list
ANYONE DRUMMING THEIR
FINGERS ON THE COUNTER
OR LEANING HALFWAY
INTO THE DISPENSARY
CAN BE SLAPPED
It was a quiet day in the pharmacy so I opened my
paper, only to read the front page headline:
"Deputy PM Nick Clegg says: Tell us the laws you
want scrapped!" It was all I could do not to phone
Parliament and shout, "Oh, oh, please - can I go
first!", because number one has got to be
decriminalising dispensing errors, followed closely
by the responsible pharmacist legislation.
Then really, the Medicines Act as a whole could
do with reform. Run out of your tablets? Sign this
simple form so that I can give you a week's supply
and charge it to the NHS. Methadone script
doesn't account for weekends or bank holidays?
Allow me as a registered healthcare professional
to alter it as necessary, and for this to be counter-
signed by a pharmacy technician, so that we can
supply what is needed - on CDs or any script for
Why did no one think of this before? Think of all
those administrative procedures and forms that
could be resolved at a stroke, such as the
ludicrously cramped discharge letters sent from
our local hospital. These were designed by
committee, so every department's information is
crammed onto one side of A4. This means that a
third is a big blank space for the briefly scrawled
diagnosis - usually something really astute and
specialised such as "Off legs" - while the truly
important bit about the discharge drugs is
squeezed into the bottom three inches.
And why stop there? If this really is going to be
an open government, for the people, then I know
all pharmacists would love to be 'king for a day',
because there's so much wrong with the NHS
world. If I were in charge, no surgery would have
an automated telephone answer system, a sort
of electronic doctor's receptionist that is even
more effective at preventing contact with
patients, and at delaying busy healthcare
colleagues with urgent queries. Manufacturers'
quotas would be banned, any patient with more
than three items would automatically have to call
back the next day, and anyone drumming their
fingers on the counter or leaning halfway into the
dispensary can be slapped.
So that is sort of why I am almost excited abou
the old RPSCB being scrapped. The CPhC
consulting on new standards, a new professional
body, devolved powers, a new 'branch network' of
local practice forums, an ever-strengthening band
of clinical pharmacists at PCT determining
contracts through pharmaceutical need instead of
commercial need, and prescribing pharmacists
within GP surgeries. For those of us who
remember PIANA - this is that new age!
Maybe it's coalition euphoria, and just as the
new government won't end wars and poverty, I do
realise there are more challenges for pharmacy to
tackle. But I have to say that I have feared for my
profession a lot more in the past than I do now,
and "Tell us what to change" isn't a bad slogan for
the new PLB either.
In search of the entrepreneurial spirit
I have spent a remarkable few weeks
filming The Victorian Pharmacy for
BBC2. It has been great fun and I
hope the series and accompanying
book will help community pharmacy
get the recognition it deserves.
The four one-hour programmes
(to be aired on BBC2, hopefully this
autumn) follow the development of
pharmacy from the early Victorian
period, in the 1840s (when I make
up Oil of Earthworm, for example),
through to the late 1800s (when I
make gunpowder and fireworks). The
other two presenters are Ruth
Goodman and Tom Quick, historians
from whom I learned a great deal.
What came over to me most
strongly was the entrepreneurial
spirit of the Victorian pharmacists.
Many of them had to fight to make a
living (the pages of the C+D used to
list those who had gone bankrupt) so
they were certainly inventive.
A modern pharmacy is an
illustrated history of our forebears'
willingness to tackle anything to
provide the public with what it
wants. People sometimes ask why
pharmacies stock anything other
than medicines, and the answer is
because we were the experts in the
high street in chemicals, plant
extracts and health.
Why perfumes? Because we had
expertise in essential oils and used
to blend our own perfumes. Why
shaving equipment? Because we not
only made shaving preparations but
also shaved customers. Why reading
glasses and dental care? We used to
make tooth powders, extract teeth,
test eyes and fit glasses. Indeed, the
Pharmaceutical Society was formed
decades before the equivalent
dentistry and optics bodies. The list
goes on: photography, sexual health,
dermatologicals, etc. Whatever the
public wanted, we bought, made or
created a service for it.
We need that Victorian
entrepreneurial spirit now.
Community pharmacy faces the
worst financial depression for over
half a century. It is tethered to
dispensing, for which it will inevitably
get less money; the commissioning
of clinical services by the PCTs is, to
put it mildly, variable in its quality,
insight and effectiveness. We need
to reconnect to our customer base,
to talk to them and offer the services
- NHS funded or private - they want.
And we need not be afraid of
charging for them. For example,
those of us in middle age who live
far from our parents would be willing
to pay a lot of money for the peace
of mind that could come from a
pharmacist engaging with our
parents and helping manage their
medicines (including, occasionally,
helping challenge their GP).
We will see some innovative
practices celebrated in next month's
C+D Awards. We need more. Engage.
Professor Nick Barber, Centre for
Medication Safety and Service
Quality, The School of Pharmacy,
University of London
OR CREATED A
SERVICE FOR IT
14 Chemist ---Druppist 29.05.10
Weight loss benefits
beyond what the
eye can see
alii is the only non-prescription
weight loss medicine licensed
throughout Europe. A new
three-month study* has shown
that alii, when used with a
reduced calorie, lower-fat diet,
not only significantly reduces
total bodyweight but also the
harmful excess visceral fat 1
that can contribute to diabetes
and heart disease. 2 '
Help customers understand the
meaning of healthy weight loss.
Talk to them about visceral fat
and positive change with alii.
alii is for overweight adults with BMI > 28 kg/rrf
Open-label 3-month study in 24 individuals with BMI > 28 kg/m J
and increased waist circumference. Visceral fat measured at
baseline and endpoint.
60 mg hard capsules
Positive change from
the inside out
Product Information, alii 60 mg hard capsules (orlistat)
Indication Weight loss in adults BMI > 28, Dosage: Adults
(18 or over). One capsule within an hour of each of three
main meals. Max. 3 caps/day for up to 6 months Use with
lower fat mildly hypocaloric diet If no weight loss within 12
weeks refer to HCP Diet and exercise should start prior to
treatment Contraindications Hypersensitivity to ingredients,
concurrent treatment with oral anticoagulants or ciclosporin. chronic
malabsorption syndrome; cholestasis, pregnancy, breast-feeding Special
warnings and precautions See GP if kidney disease, on amiodarone, levothyroxme or medication
for diabetes or epilepsy See HCP if on medication for hypertension or hypercholesterolemia
Risl- of Gl symptoms increases with fat consumption Take multivitamin at bedtime See GP if
rectal bleeding Oral contraceptive efficacy may be reduced if severe diarrhoea, use additional
contraception Drug interactions Ciclosporin, oral anticoagulants, levothyro/ine. antiepileptics, fat
soluble vitamins, acarbose, amiodarone Pregnancy and lactation Do not use during pn gnai
or lactation Side effects See SPC for full details Predominantly gastrointestinal eg oily stools,
urgency, usually mild arid transient, risk reduced by low fat consumption. Pancreatitis, oxalate
nephropathy, hepatitis, cholelithiasis, abnormal liver enzymes, anxiety, hypersensitivity reactions
including anaphylaxis, bronchospasm, angioedema, pruritus, rash, and urticaria, bullous eruption
Legal category f Marketing Authorisation Holder Glaxi i Group Limited
UB6 ONN MA Number EU/1/07/401/007 & 009 Pack size and RSP (excl. VAT) ' 8.1 i! .. 84s £4 3.43
Last revised I lovember 2009 References 1
Health Organisation The challenge of obesity in
the WHO European region and the strategies
for response 2007 Available at wwweurowho
int/document/E89858pdt Accessed 14/1/10
data on file 2010 (visceral fat study 11 2 World
M /PharmAssist. co.uk
alii is a registered trademark of the GlaxoSmithKline group of companies
r CPD with
45+ modules per year
Online assessment with immediate results
CPD log sheet with every module
Suitable for pharmacists and technicians
Flexible and cost-effective
Delivered through C+D and online
Call 0207 921 8425
online at www.chemistanddruggist.co.uk/ui
of the nervous system
Port 2 drugs that act within thi- central nervous system
8 5 Minute Test
Until mdw i'd pmblcirr, nf triL- ncrvniis system (port 2)
.. ... , |
HOW TO r 'CC(STR ; ;- ,„'":''.._.„
Update Esd I
My CPD log _
Drug-induced problems of the nervous system ] ^^£em
To get Update articles sent free to your inbox each week, sign up to
C+D's clinical newsletter at www.chemistanddruggist.co.uk/register
17 MUR cases ► 19 Prescribing ► 20 Euro Rxs ► 22 Work safety ► 26 Design awards ► 29
MUR case studies
A woman with diabetes has tingling hands and feet, while a heart
failure patient reports an upset stomach. What do you advise?
ChinjalJ Patel MRPharmS PC Dip
Two case examples highlight issues to consider
when carrying out medicines use reviews.
Diabetic neuropathy, hypertension and
People with type 2 diabetes are at a high
cardiovascular risk, which can be reduced by an
appropriate reduction in blood pressure and
cholesterol, together with dietary changes. Some
antihypertensive drugs can interfere with blood
glucose and lipid levels, while the side effects of
hypoglycaemics may result in patient non-
compliance, leading to diabetic neuropathies
caused by hyperglycaemia.
Diabetic neuropathies are nerve disorders
caused by both type 1 and type 2 diabetes. They
occur because of decreased blood flow and
hyperglycaemia, and are more likely if blood
glucose levels are poorly controlled. The types of
neuropathy can be grouped as peripheral (most
common), autonomic, proximal or focal. 1
Peripheral neuropathy causes pain or loss of
feeling in the hands, arms, feet and legs.
Autonomic neuropathy commonly affects the
gastrointestinal and genito-urinary systems. It can
also affect the heart, lungs and eyes as well as
cause changes in perspiration. More importantly, it
can mask the warning signs of low blood sugar
leading to hypoglycaemia.
Proximal neuropathy is associated with the
motor neurone system, causing pain and weakness
in the thighs, hips and legs. Focal neuropathy (also
called mononeuropathy) damages specific nerves.
It can cause more severe pain and often has a
sudden onset but usually only short duration.
Common treatments for diabetic neuropathies
include antidepressants and anticonvulsants. 2
Supported by jp^j
Mrs Collins is a 51 -year-old hypertensive with
type 2 diabetes and high cholesterol. She asks
about your free medicines use review service as
she is worried she will end up on insulin. She
comes in later with a bag of medicines, most of
which match up with the medicines on her PMR.
However, there are other medicines she has bought
OTC and some she has obtained from her family.
Current medication from PMR
Metformin 500mg ltds
(titrated up over last two years)
(titrated up over past six months)
Ramipril 5mg caps 1od
(increased from 2.5mg 1od two months ago)
Bendroflumethiazide 2.5mg 1om
(started six months ago)
Simvastatin 40mg 1od (started six months ago)
Aspirin 75mg disp tabs 1od
(started six months ago)
Amitriptyline 10mgtabs 1on
(started six months ago)
Duloxetine 60mg tabs 1od
(started two months ago)
s Lactulose solution 15ml bd
(started six months ago)
Evening primrose oil
Indigestion tablets containing calcium carbonate
Calcium and vitamin D
Obtained from family
Cold and flu caplets.
When Mrs Collins was started on metformin,
she reverted back to her old eating habits, thinking
the tablets would do the trick now. Her blood
glucose levels became progressively higher so the
CP introduced gliclazide. However, she has noticed
weight gain and tingling pain in her hands and feet,
with aching legs.
Believing the weight gain and neuropathic
symptoms to be caused by gliclazide, she recently
decided to take only one tablet daily Her CP
prescribed some anti-depressants for the pain but
she doesn't like taking them.
lnixicu poinxs co ci
Non-compliance with gliclazide can put her at
high risk of diabetic complications - are her
symptoms due to diabetic neuropathy?
The cold and flu product contains a
decongestant and is not suitable in high blood
pressure or diabetes.
Are the aching legs a sign of diabetic neuropathy?
Or is it myalgia from simvastatin or ramipril 7
Looking <ai the inedication
Type 2 diabetes (metformin, gliclazide)
Did the gliclazide cause the weight gain 7
Why hasn't the metformin dose been
Diabetic neuropathy (amitriptyline, duloxetine)
How compliant is the patient?
Duloxetine has been prescribed for two months,
29.05.10 Chemist -Druggist
r 18 MUR cases ► 19 Prescribing ► 20 Euro Rxs ► 22 Work safety ► 26 Design awards ► 29 Away days
and it seems Mrs Collins still has the neuropathic
symptoms. The BNF 59 3 says discontinue
duloxetine in diabetic neuropathy if there is no
response after two months.
Hypertension (ramipril, bendroflumethiazide)
Bendroflumethiazide can aggravate diabetes by
causing hyperglycaemia and may alter plasma lipid
Did the ramipril cause aching legs?
' Did the simvastatin cause aching legs?
Is the aspirin causing gastric problems? Could
this explain the use of indigestion tablets?
© Lactulose can sometimes affect diabetes control.
@ What caused the constipation - amitriptyline,
calcium or indigestion tablets?
OTC medicines as above
The calcium and indigestion tablets can cause
Hypertension, iron-deficiency anaemia
and heart failure
Hypertension is a major risk factor for developing
heart failure, which is commonly characterised by
fluid retention, breathlessness and fatigue. Non-
cardiac conditions, such as severe iron-deficiency
anaemia, can also predispose to heart failure. 5 The
main types are left ventricular systolic
dysfunction (where the left ventricle doesn't
pump as efficiently as it should during each
heartbeat), diastolic dysfunction (where the left
ventricle doesn't efficiently fill up with blood
between each heartbeat when the heart is
resting) or a combination of the two.
Mr Taylor is a 61 -year-old regular customer. He is
a vegetarian and doesn't have an iron-rich diet so
takes prescribed ferrous sulphate.
Six months ago Mr Taylor, who is also on anti-
hypertensive medication, had a fall and while in
hospital was given ibuprofen for back pain, which
he continued to take after discharge without his
GP's knowledge. Further tests in hospital
diagnosed heart failure.
Today Mr Taylor asks for the best remedy for a
cold he has had for about a week; he has also lost
his appetite. He has just returned from a holiday
abroad suffering from nausea and diarrhoea, which
he believes is due to a stomach virus. You notice
from his PMR that he is on multiple medicines
including digoxin and say he is an ideal candidate
for an MUR, to which he agrees.
Current medication from PMR
® Losartan 50mgtabs lod
Furosemide 40mgtabs 1od
Digoxin 125mcgtabs 1od
Bisoprolol 5 mgtabs lod
® Simvastatin 40mg tabs 1od
© Ferrous sulphate tabs 200mg ltds
s Ibuprofen 200mg tabs 1- 2tds pm (prescribed
from a previous hospital admission, and then
bought from GSL section).
® Cod liver oil for joints.
Initial points to consider
® Is the nausea, diarrhoea and loss of appetite due
Because of side effects with gliclazide, Mrs
Collins hasn't complied with the dose. You
reassure her that gliclazide can sometimes cause
weight gain but, if she is not fully compliant, the
resulting hyperglycaemia can lead to further
diabetic complications and aggravate her
neuropathy. Amitriptyline makes her tired the
next day. She has not been fully compliant with
the duloxetine. However, she complies with all
the other prescribed medication but does not
need the lactulose. You say she should discuss
further treatment options with her CP. You say
that the cold and flu caplets are not suitable and
she should check with a pharmacist or GP before
taking non-prescribed medication.
Would you suggest any medication changes?
Gliclazide: GP to review. Metformin: GP to
review dose. Lactulose: not required anymore.
to digoxin? Did a virus cause the loss of appetite?
Could the symptoms be due to a poor diet abroad?
The diarrhoea can cause hypokalaemia, which
can further lead to digoxin toxicity.
© Is the GP aware the patient is taking ibuprofen?
NSAIDs can impair renal function, raise blood
pressure and cause salt and water retention,
making heart failure worse.
Looking at Mr Taylor's medication
Iron-deficiency anaemia (ferrous sulphate)
s Is he fully compliant with the ferrous sulphate?
(Inadequate iron levels can aggravate heart failure).
Heart failure and hypertension (losartan,
digoxin, bisoprolol, furosemide)
® Is the patient fully compliant?
® Losartan can cause diarrhoea, taste disturbance,
fatigue and anaemia.
Ferrous sulphate gave Mr Taylor diarrhoea on
holiday, so he substituted it with iron-rich
foods. You explain that iron is essential for the
heart and that dietary intake alone would not
replenish his deficiency. You ask him if his GP
knows he is taking ibuprofen, as it can affect
digoxin levels. He hadn't told him. The
combination could raise his digoxin level, which
may be linked to his nausea and diarrhoea,
by his iron-deficient state. In addition, ibuprofen
can cause internal bleeding, worsening anaemia.
You mention you will make your
recommendations on the MUR form to his GP
and suggest steam inhalations for his cold, with
advice to see his GP if there is no improvement.
Would you suggest any medication changes?
Digoxin: GP to review - could be signs of
Discussion with GP
You contact Mrs Collins' GP about the
hyperglycaemia, most likely resulting from
non-compliance with gliclazide. She also has
signs of neuropathic pain, which could be due
to hyperglycaemia and non-compliance with
the antidepressant. The GP agrees and asks
you to refer her to him. You post him a copy
of the MUR.
Counselling points for the patient
Advise regular blood glucose, BP and
Take metformin with or after food.
Avoid grapefruit juice, as it interacts with
Advise on healthy diet - low in fat and salt.
Provide patient information leaflets on
diabetes, high blood pressure and cholesterol.
Hypokalaemia from furosemide may be further
aggravated by recent diarrhoea.
Is any hypokalaemia causing digoxin toxicity?
a Furosemide can cause nausea and Gl problems.
® Can cause anaemia and gastrointestinal effects
including abdominal pain, diarrhoea and nausea.
References are available online at
Chinjal J Patel is a community pharmacist in
Download a CPD log sheet that helps you
complete your CPD entry when you
successfully complete the 5 Minute Test for
this Update article online (See p19).
digoxin toxicity. Ibuprofen: GP to review.
You contact the G P about the ibuprofen
interacting with the digoxin, which may be
linked to the nausea and diarrhoea. The GP has
no record of this. He asks you to refer him for a
review. You send a copy of the MUR.
Advise an annual flu vaccination.
Advise vaccination against pneumococcal
disease (only required once).
Reduce salt, avoid excess fluid intake, avoid
alcohol and advise on regular exercise.
Check patient can recognise signs of cardiac
failure worsening: breathlessness, ankle swelling,
fatigue and sudden weight gain.
Monitor renal function, urea, creatinine and
The first of two articles on
blood tests looks at interpreting
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Sign up for the CPD Bulletin at www.chemistanddruggist.co.uk/clinicalindex
What is autonomic neuropathy? Why might patients
taking gliclazide be non-compliant? What are the side
effects of losartan? Why should ibuprofen be avoided in
Using two case studies as examples, this article discusses
problems that may occur with drugs used in type 2
diabetes, high cholesterol, hypertension, anaemia and
Read the MUR tips for type 2 diabetes and heart
failure on the C+D website at http://tinyurl.com/39dttuf
» Find out more about diabetic neuropathy from the
Patient UK website at http://tinyurl.com/3xetcas.
Revise your knowledge of the drugs used in treating
type 2 diabetes and diabetic neuropathy by reading
sections 6.1.2 and 6.1.5 in the BNF.
Revise your knowledge of heart failure treatment by
reading the Update on chronic heart failure, C+D April 17,
2010, p17-18, or online at http://tinyurl.com/2vgfuzg
Update your knowledge of iron-deficiency
anaemia from the Patient UK website at
Are you now familiar with the drugs used to treat type 2
diabetes, high cholesterol, hypertension, anaemia and
heart failure, and the problems they may cause? Could
you confidently carry out an MUR involving these
Registering for Update 2010 costs £37.60 (inc VAT) and can be done easily
at www.chemistanddruggist.co.uk/update or by calling 0207 921 8425.
Signing up also ensures that C+D's weekly Update article is delivered
directly to your inbox free every week with C+D's email newsletter.
Get a CPD log sheet for your portfolio when you successfully complete
the 5 Minute Test online.
David Spencer, pharmacist at the
Update Pharmacy, carries out a
quarterly analysis of a local GP
practice's prescribing data as part of
a prescribing advice service.
David raises the issue of
angiotensin-renin system drugs
(ARSDs) with senior partner Dr
David says: "I've noticed that the
cost of ARBs (angiotensin II receptor
antagonists or blockers) in this
practice is quite high and it's rising
steadily. It's rather above the Nice
David explains the relative rate of
prescribing of ACE (angiotensin
converting enzyme) inhibitors and
ARBs in the practice and the relative
costs of the drugs.
Mo replies: "Wow, I didn't realise
they were making such a hole in our
"Do you know why ARBs are being
prescribed?" David asks.
"I would imagine they are mainly
being substituted for ACE inhibitors
for patients troubled with cough side
effects. Also, I sometimes prescribe
an ARB as an add-on if a patient's BP
is not being adequately controlled on
an ACE inhibitor alone."
"As far as both those reasons are
concerned, I think the evidence
shows that prescribing ARBs is
generally not necessary or justified,"
David replies and goes on to
demonstrate his points.
"Well, we don't have a specific
prescribing policy for this important
group of drugs at the moment," says
Mo. "Perhaps it's time you drew one
up for us."
1. What are the relative rates of
prescribing and costs of ARSDs?
2 What are the Nice
recommendations on relative
3. How necessary or justified is
the substitution of ARBs for
cough caused by ACE inhibitors?
4. How justified is prescribing of
ARBs alone or in combination
with ACE inhibitors for
hypertension and other conditions?
1. In primary care in England, about
70 per cent of ARSD prescribing is for
ACE inhibitors, with 30 per cent for
ARBs. But ARBs account for 70 per
cent of the total spend on ARSDs.
2. 80 per cent ACE inhibitors/20 per
cent ARBs. This would represent a
saving of around 23 per cent on the
£300 million annual cost of ARSDs
in England alone. Only about 12 per
cent of GP practices achieve this.
3. The major benefit of ARBs over
ACE inhibitors is their lower rate of
cough. However, cough may not be
as common with ACE inhibitors as is
perceived: the percentage of people
reporting cough in randomised
controlled trials is about 10 per cent,
and as low as 2 per cent in
observational, real world studies.
Discontinuation rates due to cough
are lower: only 4.2 per cent of
patients taking an ACE inhibitor
stopped treatment because of cough
compared with 1.1 per cent taking an
ARB. 1 Cough sometimes results from
other, overlooked, causes, eg
4. For hypertension and all other
indications, ACE inhibitors are the
first-line choice. 2 An ARB alone is
only indicated if an ACE inhibitor is
discontinued because of intolerable
cough. There is generally no benefit
in prescribing an ACE inhibitor plus
an ARB, and outcomes are often
worse than with an ACE inhibitor
References are available online at
:L 1 . CLINICAL PROFESSIONAL PRACTICE ESS
1 17 MUR cases 4 19 Prescribing 20 Euro Rxs 22 Work safety 26 Design awards ; 29 Away days
This series aims to help you make the right decisions when confronted by an ethical dilemma. Every month we present a scenario likely to arise in a
community pharmacy and ask a practising pharmacist and/or a member of the Pharmacy Law and Ethics Association (PLEA) to comment on the legal and
ethical implications of the actions open to you. Readers are invited to have their say at email@example.com
prescription from Europe
he arrangements to dispense overseas
prescriptions apply only to European
Economic Area (EEA) and Swiss-
registered doctors and dentists and do not extend
to any Controlled Drugs, including Schedule 5
CDs, nor medicines that do not have a marketing
authorisation in the UK. A pharmacist is not
compelled to dispense EEA and Swiss
prescriptions and if he or she does dispense it the
prescription will need to be treated as a private
one and incur normal private dispensing charges.
There is no requirement for additional
information to be on these prescriptions beyond
what is required for a UK prescription under the
Medicines Act 1968. However if a specific brand
name is specified then that must be supplied.
Before deciding whether to dispense the item,
you will need to consider whether the person who
has signed the prescription is indeed a registered
doctor or dentist in an EEA country or in
Switzerland. You will have to make adequate
checks - the web links for the regulators of these
practitioners are available from the RPSCB - and
to consider whether there may be language
barriers if you need to query the prescription with
If you feel you do not have sufficient
understanding of the language in which the
CPD Reflect • Plan • Act • Evaluate
prescription is written, it may not be possible to
dispense the prescription safely or to counsel the
patient effectively. In this case all reasonable
steps should be taken to try to assist the patient
to get the medicine.
Professionally you will need to be competent
and recognise your duty of care to the patient as
well as exercise your judgement in the patient's
interests - code of ethics principles 1 and 2. In this
case the patient is asthmatic and, while not
actually suffering symptoms at the moment, he
should have a salbutamol inhaler to provide
immediate relief if he experiences an exacerbation
of his condition. Principle 5.3 requires you to
"recognise the limits to your professional
competence and practise only in those areas you
are competent to do so". Principle 7 requires you
to take personal accountability for your own
decisions, behaviour and work.
Emergency supplies are allowed at the request
of the patient (or the prescriber) for medicines
previously prescribed by an EEA or Swiss doctor
(or dentist) so if you are convinced the patient
needs an inhaler and feel this judgement is within
your competence, you could take up this option.
Ruth Rodgers, MRPharmS, PhD, senior/
clinical lecturer in pharmacy practice,
Medway School of Pharmacy, Universities of
Kent and Greenwich
We and our clients have encountered practical
difficulties in verifying whether a prescription has
been written by an EEA doctor. These difficulties
hinder the ability of pharmacists to dispense EEA
prescriptions to meet patient needs.
The RPSCB's Guidance Note, "A Practical Guide
to Dispensing EEA and Swiss Prescriptions",
contains web links to assist in checking
registration details. However, many of these are
simply links to the GMC website, which provides
contact details (often postal) of the EEA
registration body. When faced with an EEA
prescription, it is impractical for a pharmacist to
write or email the appropriate regulatory body to
seek confirmation of the practitioner's registration
status (and, indeed, when we have tried on behalf
of clients, the regulator has not responded).
In the above scenario, if the pharmacist were to
use the Society's link he would be directed to (it
would appear) the German equivalent of the BMA,
not the GMC.
Until there is a method by which pharmacists
can check the registration details of all EEA
doctors online there will be practical difficulties in
allowing access to UK pharmacies for patients
who have EEA prescriptions.
Noel Wardle is a solicitor with Charles Russell
LLP, specialists in pharmacy law
More dilemmas are online at www.chemist
PLEA is an association of
pharmacists interested in
law and ethics, and lawyers
or ethicists specialising in
pharmacy, with the aim of promoting
understanding of the ethical basis for
20 Chemists-Druggist 29.05.10
A single step forward in BPH management
Combodart, offers rapid, sustained and superior
symptom improvement, with significant reductions in
Acute Urinary Retention and BPH-related surgery vs
tamsulosin in one capsule, once a day u
COMBODART £l y
(dulasteride /tamsulosin HCI) Capsules
Discover the difference
kombodart Fixed Dose Combination
15 mg dutastende and 04 mg tamsulosin hydinchlonde iliaid capsules) Uses Die
'eaiment of moderate to severe symptoms of benign prostatic hyperplasia (BPH)
.eduction in the risk of acute urinary retention (AUR) and surgery in patients with
lodetate to severe symptoms ol BPH Dosage and administration (Adults including
Iderly) The recommended dose of Combodart is one capsule (0 5 mg/ 4 mg) Wen
(ally appronmately 50 minutes attei the same meal each day, Die capsules should be
wallowed whole and not chewed oi opened No dose agistment is necessary in the
Iderly Caution is patents with mils lo moderate hepatic in payment In patient, with
ewe hepatic impairment, the use of Combodart is coiiltaindicated. Wlieie appropriate,
Combodart may be used to substitute concomitant dutastende and tamsulosin
ivdiocliloride in easting dual therapy to simplify treatment Where clinically appropriate,
lired change trom dutastende or lamsulosm hydrochloride monotherapy to Combodart
may be considered Contra-indications Use in women, children and adolescents Known
lypeisensiliyity to dutastende, other 5-alpha leductase inhibitors, tamsulosin (including
amsulosin- induced angio-edemal or any ol the excipients Patients with a history ot
irthostatic hypotension Patients with severe hepatic impairment Special Warnings and
'recautions Combodart should be prescribed alter careful benefit risk assessment due to
he potential increased nsl of adverse events and alter consideration ol alternative
raiment options including monotherapies In a 4-yeai clinical study, the incidence of
ongestr/e cardiac lailurel was higher among sublets taking the combination of
lutasleude and an alpha blotter lamsulosm, lhan il was among subjects not fating the
ombmation Ho causal relationship between dutastende (alone or in combination with
in alpha Mocker) and cardiac failure has been established Digital recta! eiamination, must
le performed on patients with BPH prior to initialing therapy with Comhndart and
Mediately with soap and water Use with caution in patients with mild to moderate
by approximately 50% after 6 months in patients with BPH, even in the presence of
prostate cancer Iheiefore in palients treated (or sin months or mote, PSA values should
in PSA levels while on Combodart should be carefully evaluated The ratio ol tree ro total
PSA remains constant even under the influence ot Combodart II electing to use percent
ad|ustment to its value appear, necessary The treatment of severely renally impaired
patients should be approached with caution as these patients have not been studied As
tamsulosin, as a result ol which, taiely, syncope can occut Patients beginning treatment
with Combodart should be cautioned to sit oi lie down at the list signs of orthostatic
hypotei ' imp! I live Flo|
been observed during cataract surgery in some patients on oi previously treated with
tamsulosin This may lead to mcK-ased pun edural complications doing the operation The
nation ol therapy wil
is therefore nor recommended Interactions There have been no drug interaction studies
fa Combodatl Dutastende In vitro studies Dutastende mainly eliminated via
administered orally) may increase serum concentrations ol dutastende No effect on the
pharmacokinetics ot waitann, Jigoxin, lamsulosm oi terazosin Tamsulosin
blood pressure, including anaesthetic agents and other alpha-l adieneigic blockers could
/potensive effect I be used
dulasteiide-larnsulosm is used in combination with cimetidme Caution should be
nleiaelions at the levi
liver microsomal fractions, involving amitnptyline, selbutamol and glibenclamide
Diclofenac howevei, may increase the elimination rate of tamsulosin Pregnancy and
lactation Combodart is contraindicaled in women There have been no studies to
investigate the etled ol Combodart on pregnancy, lactation and fertility fertility
Dutastende r!-;».'Vi • semen cbaradeistcsneduction n spems count, :emer
volume, and speim motility) in healthy men Possibility ot reduced male fertility cannot be
excluded Tamsulosin Effects ol lamsulosm hydrochloride on sperm counts « sperm
function have not been evaluated Pregnancy Dutastende Small amounts ot dutastende
have been found in semen ol subjects receiving dutastende 5 mg As with all 5-a!pha
leductase inhibitors, a condom is recommended tot use in patients when then partner is
or may potentially become pregnant to avoid exposure to semen Jmsulosm
Administration ot tamsulosin hydrochloride to pregnant lemale rats and rabbits showed
no evidence ot loelal harm Lactation Not known whether dutastende oi lamsulosin is
■ v : Effects on ability to drive and use machines '. m-
the effects of Combodart on the ability to drive and use machines have bee
Howevei, patients should be informed about the possible occurrence ol symptom, related
to orthostatic hypotension such as dizziness when taking Combodart Side effects Tre-e
have been no therapeutic clinical trial; conducted with Combodart, howevei
bioeguivalence ot Combodart with co-administeied dulasteride and tamsulosin has been
■ s M redudion en Crux was observed tor the lamsulosin component in
the ted state compaied to the lasted state Food had no effect on AUC ol tamsulosin
Dutastende monotherapy clinical trials Higher incidence with dutastende than placebo
groups Impotence, altered (decreased) libido, ejaculation disorders, breast disorders
(including breast enlatgement and/or breast tenderness) Post marketing reports Allergic
readion; including rash, pruritus, urticaria, localised oedema and angioedema
Dutastende in combination with the alpha blocker tamsulosin • 4 year clinical data
(CombAT) Highet incidence in the combination therapy group tn the tirst year ot
treatment due to highei incidence ol reproductive disorders, specifically emulation
disorders Other lepiodurtive disorders Impotence, altered (decreased) libido Breast
CombAT 4 yeai BPH study, the incidence ot the composite term cardiac failure in the
combination group was highet than m enter monotherapv group and similar to the sum
ol the two different types ol therapy Legal category POM Presentation and Basic
NHS cost Combodart 5 mg dulasteride and 04 mg tamsulosin hydrochloride lhaid
capsules! £19 80 per 30 capsule pa:i Produd licence number 19494/0046 Produd
licence holder GlaxoSmithKline UK ltd, Stoclley Part West, Middlesex, UB1 1 IBT
Prescribing information updated April 2010
Adverse events should be reported. Reporting forms and information
can be found at www.yellowcatd gov.uk Adverse events should also
be reported to GlaxoSmithKline on 0800 221 441.
wmai Date ot preparation April 20 iO
The recommended dose ol Combodart is one capsule '0 5 mg' 4 mg) taken orally
swallowed whole and not chewed or opened
1 Combodart Summao/ ol Produd Characteristics. 2010
2 RoehibomCGefal Eur Urol 2010, 57 123-131
17 MUR cases ^ 19 Prescribing 20 Euro Rxs "W 22 Work safety p 26 Design awards |> 29 Away days
Health and wellbeing at work is important for both employees and pharmacy businesses - without healthy happy staff, customer service is likely to
suffer. Over the coming months C+D will be giving you guides and tips on improving your wellbeing, covering everything from boosting morale in the
dispensary to your legal rights. If there is a health and wellbeing issue you would like us to cover, firstname.lastname@example.org.
YOUR HEALTH AND WELLBEING ATWORK
Accidents will happen
Would you know what to do if the worst happened? Zoe Smeaton explains how
to prevent accidents in the pharmacy - and how to cope if they do occur
What to do if you have an accident at work
1. Report it to someone in authority at your organisation
2. Record any injury in the accident book as soon as
3. If you need to, make sure your employer has
reported the accident to the HSE
Hit, 4. Check your contract or written statement of
employment for information about sick or
5. If there's a dispute, try to sort it out
L with your employer
6. If you still have problems
|n> contact the HSE Infoline
0845 345 0055
nything can happen in a pharmacy,"
says David Reissner, head of
healthcare at law firm Charles Russell.
Although accidents might seem unlikely - things
can and do sometimes go wrong in dispensaries,
he reveals. From trips and falls to needlestick
injuries, there are many ways in which
pharmacists can come to harm.
And although the government's Health and
Safety Executive (HSE) says health and safety is
primarily the responsibility of employers, it
stresses that workers have a legal responsibility
too. And, perhaps more importantly, it says
workers who contribute to health and safety
at work are safer and healthier than those who
Janice Perkins, superintendent at the
Co-operative Pharmacy, agrees: "It is the
responsibility of all colleagues to work in a way
that protects both customers and co-workers so
that a positive attitude towards health and safety
is adopted throughout the business."
So how can you help make your pharmacy a
safer place to work in?
Your employer has a duty to protect you and to
provide health and safety training, so the first
thing you should do is to make sure you pay
proper attention to this and are aware of the risks.
Try to apply any training to your own dispensary,
considering how specific working processes could
be adapted to make them safer. You could also
check there are adequate first aid equipment and
facilities and precautions against fire.
Think about the type of accidents that could
happen in your pharmacy. The NPA says falls are
common, with boxes left in walkways and wet
floors commonly cited as factors.
Ms Perkins adds: "Some of the most common
accidents at work involve slips and trips, but
these can be avoided if people are observant, work
in a tidy and organised way, wear suitable
footwear and remove any obstacles that may
cause a fall."
With the expanding clinical role of pharmacists,
there may also be some additional risks creeping
in. As Bruce Dixon, head of health, safety and
environment at Lloydspharmacy, explains: "As it is
a healthcare environment, there is always a risk in
pharmacy, albeit very low, of a more serious
accident occurring, such as needlestick injury.
Despite the low incident rate, Lloydspharmacy is
continually raising awareness of this risk and
preventing needlestick injury is the current health
and safety focus for the company."
However, if you carry out your own risk
assessment you'll be able to identify the risks
and you can then work on ways to minimise
them. You might need to talk to your employer's
health and safety advisor or team about this so
they can help improve practice, and if they aren't
being helpful you can always contact the HSE
without fear of getting into trouble if you still
With all the prevention in the world, though,
sometimes things will still go wrong. So what
should you do if an accident does happen?
When accidents happen
The first thing to do after an accident occurs and
any injuries have been dealt with is to report it
to someone in authority at your company. This
could be your immediate line manager, the
pharmacy manager, or possibly the proprietor if
it's a small business.
Then an entry should be made in the accident
book as soon as possible, Mr Reissner says. As
well as giving you a record of the incident
should you need it at a later date, this also helps
to maintain health and safety standards. As
charity Pharmacist Support says: "It means
that you're allowing the employer to maintain
their duty of care to employees. By being
informed of any issues you are enabling them
to take any measures necessary to avoid a
recurrence in the future, making the environment
safer for everyone."
Many companies will have formal accident
reporting and recording processes for you
cream ^ fV
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Vaseline has 1 40 years of skincare expertise, and the Vaseline Intensive
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Several factors can contribute to dry skin. Everyday use of soaps and
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To bring dry skin back to health and keep it healthy, it is important
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• Maintains and instantly increases water content in the skin
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17 MUR cases 4 19 Prescribing 4. 20 Euro Rxs W 24 Work safety ^ 26 Design awards (► 29 Away daysl
Carrying out a risk assessment in the pharmacy makes it possible to devise ways to minimise them
to follow and to help them learn from incidents.
The Co-operative Pharmacy, for example, has an
online reporting tool that transmits details of
incidents to their health and safety team, and at
Lloydspharmacy accidents are reported to head
office, also via a back office electronic accident
If you have had a serious accident, your
employer is required to notify the HSE and inform
their insurer, so you should also check they have
done those things when you can. In such cases you
may need to take time off work or even claim for
compensation if the accident was not your fault.
If you do need time off because of your injury,
you should be getting statutory sick pay and you
might even be able to claim benefits to boost your
income when you are off work or when you go
back to work. There may also be measures in place
to help you if you have to stay off work following
an accident. The NPA says its employers' liability
insurance provides for funding rehabilitation in
appropriate circumstances, to help people return
to good health and work as soon as possible
following an accident. And as Mr Dixon says: "If
we can assist an employee back to work then we
will refer them to our medical rehabilitation
partner. If a colleague has been involved in an
accident that has caused them some distress, then
we will make an offer of counselling to help them
through this difficult period."
If the accident was not your fault and your
employer has been negligent or in breach of a
statutory duty, then you will be able to make a
claim against them. This is where your employers'
liability insurance, which all employers are legally
required to have, will kick in. Mr Reissner advises:
"If an accident is down to the fault of the
employer, as sometimes happens, then the
employee should write to the employer. The
employer should then ensure that they promptly
pass any complaints to their insurers."
Mr Reissner says in practice the insurance
company will then take over the handling of any
claim, dealing directly with the employee. This can
make it easier for everyone involved, especially if
the employee and employer are still working in
the same place, he says.
You might need a solicitor to make a claim like
this, or you could try seeking support from the
Pharmacists' Defence Association or contact the
HSE yourself. You can also contact Pharmacist
Support, who can give information and provide a
referral for specialist advice on employment law
and benefit entitlement.
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"As a business we undertake regular risk
assessments and branch audits to ensure
staff are complying with HSE recommended
guidelines to minimise any potential risks to
staff and any other individuals who are on
the premises. We have a detailed health and
safety manual for employees to follow. In
addition to this we provide e-learning
modules to educate pharmacists and branch
staff about when and how they should
report an accident if one occurs."
Janice Perkins, superintendent,
The Co-operative Pharmacy
"Forming part of our overall health and safety
policy we have procedures for accident
reporting and investigation. Our teams are
instructed to report all accidents, no matter
how minor, to their line manager. This is in
order that it may be investigated, the cause
established and any action to prevent it
occurring again implemented. And despite
the low incident rate, Lloydspharmacy is
continually raising awareness of the risk of
needlestick injury - preventing it is the
company's current health and safety focus."
Bruce Dixon, head of health, safety and
"Boots UK has health and safety officers and
policies in place to ensure our people are
safe at work."
Spokesperson, Boots UK
CPD Reflect • Plan • Act • Evaluate
Tips for your CPD entry on safety at work
Can I make my pharmacy a safer
place to work?
PLAN Identify potential accident risks
ACT Raise risks and possible
preventative measures with health
and safety managers
EVALUATE Have new measures made the
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4 17 MUR cases 4 19 Prescribing 20 Euro Rxs 4 22 Work safety 26 Design awards ► 29 Away days
From Sir Norman Foster's
Gherkin to the iconic
Wembley Stadium, great
design is all around us.
As the winners of this
year's Platinum Design
Awards demonstrate -
cutting edge design can
be found pharmacies too.
Hannah Flliyjmnrn mpori^
Meet the design
Robotic dispensaries, three-tier
dispensing bench systems and
touchscreen technology were all used
by the winners of this year's C+D's Platinum
Design Awards in association with Ceuta
At the awards ceremony, held last week
in Marylebone Cricket Club's iconic media
centre (which won a RIBA Stirling prize for its
design), judges commented on the increasingly
innovative techniques employed in pharmacy
Gary Paragpuri, C+D editor and chair of the
judges, told the winners that the quality of
pharmacy design had improved greatly in recent
years, with more pharmacists keen to consider
"Recent winners of the Platinum Design
Awards have amply demonstrated how far
pharmacy has developed. I am sure we can all
remember when a few new shelves, a new carpet
and fascia was considered a major upgrade; but
this is a world away from the simply stunning
efforts that we are here to celebrate today," he
told the winners.
The other judges were David Mair, chairman of
awards sponsor Ceuta Healthcare; National
Association of Shopfitters president Brendan Turtle
and last year's overall winner pharmacy proprietor
And the winner is...
First prize went to Murrays Healthcare for its
newly designed business at Malvern. Along with a
cheque for £3,000, Murrays scooped the Best
Multiple Pharmacy Award.
The multiple's pharmacy in Malvern was put up
in just five weeks, according to the company, and
included the installation of a dispensing robot and
a dispensing system involving three benches.
Patients hand in their prescription at the first
bench, drugs are dispensed at the second and the
pharmacist checks and dispenses it at the third. A
quick advice counter was also installed for patients
who did not need to use the consulting room.
One of the judges said: "[This is] a good
business idea and well executed, providing a very
attractive offering and seemingly good return on
Murrays Healthcare managing director Duncan
Murray said: "We are absolutely delighted to
participate in the awards and to have won it. It's
great to hear judges saying it could be something
out of an art gallery, it is very important to us."
The pharmacy was designed by BAPTT
A close second, and winner of £2,000, was
Sutherland's Pharmacy in Kirkwall, Orkney.
Owner Torquil Clyde set out to design a new
store built to offer new Scottish services, including
the freshly finalised chronic medication service
(CMS), and was adamant he would integrate the
retail and professional elements of the business.
One of the changes made was a robotic
dispensary, which means pharmacists and
technicians spend more time on the shop floor.
Due to the offshore location of the shop,
materials for the refit - designed by Anderson
Retail Consultants - had to be shipped piece by
piece to the site. The judges described the new-
look pharmacy as "a sumptuous visual treat".
On winning second prize, Mr Clyde said: "I think
my staff enjoy working in the environment and
they appreciate the effort we have made. It is a
real uplift in our daily lives."
Primary Care Pharmacy in Nuneaton scooped
third prize and a cheque for £1,000. The company
stated one of its objectives was to provide 50
supervised consumption clients with dignity and
without affecting other patients. Following the
fitting of consultation rooms and installation of a
Methameasure methadone dispensing system, it
reports a significant return on investment.
"Blood, sweat and tears have clearly been
invested in this project," the judges said. "Definite
wow-factor and the forward planning to include
an internet pharmacy and a lobby area for out-of-
26 Chemist+Druggist 29.05.10
More pictures of the awards, sponsored by Ceuta Healthcare, can be viewed at:
Muirays Healthcare's Duncan
Hurray (top right) picked
up first prize in the Platinum
Design Awards, sponsored
by Ceuta Healthcare, for the
stunning Malvern Pharmacy
(far left). Second place
went to Torquil Clyde's
Sutherland's Pharmacy in
Orkney, and Michael Burr's
Primary Care Pharmacy
scooped the third prize
hours dispensing shows a real understanding for
future-proofing the business."
The project's designer, John Hilditch of Dollar
Rae, said: "You have to have a specific objective
and that has to be right at the beginning. You need
to focus on not just how it appears but that it is
practical and functional and efficient."
Superintendent pharmacist Michael Burr went
on to say: "Obviously, the patients are free to go
anywhere they like but a great design makes them
willing to come to you and go back to you."
The quality of entries was extremely high and
three pharmacies were awarded highly
commended certificates: Lloydspharmacy in
Epping, AE Hobbs in Tunbridge Wells, and MedicX
Pharmacy in Blackpool.
One of the USPs for Lloydspharmacy was its
beauty section. So, when a merger of two local
stores was proposed following a decline in sales in
recent years, regional director Nicholas Hougham
set out to create a new premium pharmacy model
that would combine high end retail and services. It
was designed by Lloydspharmacy 's in-house
At the awards, Mr Paragpuri said:
"Lloydspharmacy 's Epping branch is a stunning
example of great design on the high street."
Lloydspharmacy senior pharmacy designer
Darren Cotton said: "We needed to figure out how
to optimise our business and our returns on our
investment by moving into different channels that
perhaps we haven't worked in before."
AE Hobbs was also highly commended by the
panel for a refit three years in planning.
Mr Paragpuri said: "The beautiful wood finish,
the gorgeous red logo and the curved finishes all
add up to a truly impressive-looking pharmacy
and a fabulous example of how good independent
pharmacies can be."
Contractor Chee Ming Majoe said he contacted
designer Keith Anderson, of Anderson Retail
Consultants, following a C+D article on the 2008
Platinum Design Awards winner.
"What he did for us was superb," Mr Majoe said.
"He actually thought outside the box and,
[compared to] the two or three I called in before
who very much went down a particular route, he
thought of details I hadn't thought of before."
MedicX Pharmacy, which has been open less
than a year, was highly commended by the judges.
It was designed by MIP Design.
The judges said: "[It is] cracking, cutting edge
design that uses colour, layout and open space to
create a visual delight." Operations manager
Gavin Birchall said: "The MedicX Pharmacy vision
has been focused on making an environment the
patient is happy to be in, and I think it can have a
strong overall impact on a patient's health."
CPD Reflect • Plan • Act • Evaluate
Tips for your CPD entry on pharmacy design
REFLECT Does my pharmacy present a
professional image and support
PLAN Consider how a refit or smaller
layout changes could improve
image and work processes
ACT Implement refit or layout changes
EVALUATE Have public image and workflow
29.05.10 Chemist -Dru,
C+D Jobs celebrates 7,094 unique monthly users
'Jan-Mar 2010 average Omniture recorded stat
0207 921 8123
Booking and copy date
12 noon Monday prior
to Saturday publication
subject to availability
Contact: Andrew Walker
Tel: 0207 921 8123
Fax: 0207 921 8132
245 Blackfriars Road
London SE1 9UY
Lancaster, Rawtenstalt, Wigan, Leigh, Southport, Accrington & Farnmouth
When you re in-store, you can do more. When you're not tending to our customers' medical woes you could be dispensing advice
on healthy diet. In-store means in touch, in control, and right in the heart of the local community - developing your pharmacy, your way,
every day. For more information and to apply visit www.ASDA.jobs/pharmacy
We respect all our colleagues and value their differences We do not tolerate any form of discrimination or harassment
and be your
L Hero. A
You'll be touching all areas of your local community.
Last year we completed 1.5 million healthy heart
checks and this year we are even more committed to
providing community based healthcare services. So
whether you're taking a customers blood pressure or
helping people to alter their lifestyles, you will be part
of a company that's committed to Healthcare for life
at a national level.
Join us to make a real difference to people's everyday
lives, and help us to shape the future of healthcare.
We are currently recruiting
newly qualified Pharmacists in
the following locations:
North East England, Yorkshire,
Lancashire, Greater Manchester,
North Wales, Lincolnshire, Staffordshire,
West Midlands, Kent, West Sussex,
Oxfordshire, Devon, Cornwall, Somerset
In return we will offer you a competitive salary,
payment of your RPSGB fees, company pension
scheme, bonus scheme, private medical cover, interest
free loan, overtime, CPD study leave, and optional
benefits (such as buying additional holiday entitlement).
To apply please email your CV and a covering note
For a confidential discussion please call a member
of the Resourcing Team on 0800 917 8870.
For further information visit
Healthcare for life
ANDOVER & READING
Excellent rates for the right candidates.
or call 0208 2566 222
Enthusiastic Pharmacists required to manage and provide the full range
of services in our established and well supported branches within the
Oxfordshire and Bedfordshire areas.
Send your CV by email: email@example.com
or call on. 01582 560393
NO AGENCIES PLEASE
28 ruwisi 29.05.10
CLINICAL CLINICAL PROF I I PRACTICE BUSINESS CAREERS
, 17 MUR cases 19 Prescribing 20 Euro Rxs ' 22 Work safety 26 Design awards 29 Away days
Get away from it all
After C+D revealed stress levels in the sector are still soaring,
Zoe Smeaton finds a team away day could be just the thing
hen the pressures
of working in the
dispensary get on top
of you, the last thing you may want
to talk about is work. Relaxing away
from the pharmacy and trying to
forget all about it is probably high
on the agenda, so you might not
consider spending more time with
your colleagues. But actually,
getting to know the people you
work with could be just the thing to
help improve your daily life and kick
start your climb up the career ladder.
A useful way to spend time with
colleagues is to organise an away
day. This could be anything from an
afternoon walking the hills, to a trip
to your favourite local restaurant or
even organising a structured away
day through an outside organisation.
A quick online search reveals a
myriad of options offering
everything from days on team
building or conflict resolution, to
trying to prepare for new projects or
work on mission statements.
Deciding what you want to
achieve on your away day is
important, says Yvonne Tuckley,
Numark's training manager. "You
need to be clear why you are having
an away day in the first place - is it
essentially a jolly, or to enable
people to learn something, or is it
team building 7 As with anything
else, you need to have an objective
in mind "
And there are lots of options
Although planning strategies and
projects might seem a million miles
away from the dispensary, they
could apply, for example, if you were
preparing to launch a new service.
Sitting down with colleagues to plan
what you want to achieve and how
you will manage it in the dispensary
could be a useful exercise and help
get everyone motivated. Getting it
right from the beginning could make
all the difference in making it a
success, which will be good for
patients, the pharmacy and, of
course, your own career.
Perhaps a more likely option in
pharmacy is to concentrate on team
building This does need to be
planned properly, to ensure people
Rowlands Pharmacy head office staff recently tackled five community projects
will be at their best and so are more
likely to get along, but it can bring
many benefits. Asda superintendent
pharmacist John Evans says it can be
useful to get to know your
colleagues better. They might, for
example, then offer you more
support on the tough days at work.
Oryou might get to know someone
senior, who could offer career help
Suggesting an away day to your
employer in the right way could also
help your career - if they see you're
doing it for the right reasons because
you're enthusiastic about developing
yourself and about making the
pharmacy run as smoothly and
efficiently as possible, they're likely
to appreciate your approach. Boots,
for example, is a supporter of the
strategy, saying it has been offering
employees community-based team
challenges for over 10 years "as an
opportunity for colleagues to spend
time together as a team while giving
practical support to the local
community". The multiple says such
events can help raise morale but also
provide personal development
It's also worth considering that
taking on the task of arranging a
team day will require you to
demonstrate organisational and
other skills that could get you more
brownie points from your employer
Boots works with charities to
arrange its staff opportunities and
says each day has a team leader.
"The nominated team leader will
liaise with the account manager
at the charity to co-ordinate the
team challenge. We encourage the
team leader role to be taken on
by a more junior member of the
team as a development opportunity
to demonstrate leadership and
organisational skills," Boots says
If you're having trouble arranging
an away day, remember that it
doesn't have to be a full day away
from the dispensary, which can be
hard to find time for. You could try to
find time outside of work or just go
for a few hours. You might even be
able to go somewhere work-related,
which would help show extra
enthusiasm for your job. For
example, Ms Tuckley suggests going
to an event like the Pharmacy Show
or the C+D Awards together.
Whatever you choose to do,
though, as long as you're proactive
about it and try to take positives
from it, there's every chance your
away day could help both your
everyday working life and your
career. As one Boots employee
concluded after a team day: "The
team really enjoyed the day and the
preparation that went in to it.
Although it was hard work it was
Reading between the
lines of a job advert
The role: Community pharmacist at
a Cornwall independent pharmacy.
The location: Mostly based at a
busy dispensary in a Newquay
health centre, but with some work
at the business's other non-
dispensing pharmacy that is
popular with tourists.
The job: Usual dispensing activities
plus delivering services such as
smoking cessation, MURs and EHC.
The patients: Regular patients of
the health centre, rather than
Best bit: The administrative
support The pharmacist will only
be responsible for day-to-day
paperwork, with the rest being
completed by head office. As an
independent, the employer also
does not set targets for employees.
You will need: Good organisational
skills and lots of motivation to
thrive in the busy dispensary.
Only if you don't mind: Some
Saturday work at the non-
dispensing pharmacy. This role
involves giving lots of advice to
patients and making OTC sales.
Upcoming plans: The business is
open to suggestions on services or
other developments, so any ideas
you have could happen.
People power: The pharmacy often
has two pharmacists working
alongside staff such as accredited
checking technicians and dispensing
Apply if: You're happy working for a
family-run business with a friendly,
C+D was talking to Liz
Nickels, director and
company secretary of
See the job advert on page 30
and search for jobs at
CPD Reflect • Plan • Act • Evaluate
Tips for your CPD entry on pharmacy team building
REFLECT Does my pharmacy team work well together?
PLAN Consider if an away day could improve teamwork, and
therefore patient service
ACT Organise an away day or team outing, with goals in mind
EVALUATE Did activity improve team morale and has this benefited
HEALTH CENTRE PHARMACY
We are looking for an enthusiastic full time dispenser/
dispensing assistant to join our team in this busy, friendly
health centre pharmacy. Training will be provided if needed.
The ideal candidate will be working closely with the complete
health care team in order to deliver NHS service.
Please apply with a C.V. to Beran Patel at 020 8689 7127
141 Brigstock Road
Surrey CR7 7JN
■ - Jin J AY
Full time position
Busy independent pharmacy with minimal
paperwork. Competitive Salary
Private medical cover and pension
contributions. RPSGB fees paid
Drury's Pharmacy - 01637 872589
CV to Liz Nickels
1 Chester Road, Newquay TR7 2RT
or email firstname.lastname@example.org
Over 14,700* applications since launch
May 2010 Omniture recorded stat \# l^J^/U^
■ ! (^excellent + benefits + relocation)
i Fantastic opportunities at heart of Community
Email your CV to
or call on 02476 432983
■ jl Pharmacy ^
Pharmacy Manager - Shard End.
- Spacious refitted community
pharmacy with medium/busy
- Great relationships with local surgery
- Opportunities for services with a fully
staffed dispensary team
- Flexible working and 4-day week
- Genuine market-leading salary - plus
benefits and bonuses
- Ideal candidate will have strong
management experience and
enthusiasm for services
0161 429 6775
(£excellent + benefits + relocation)
: Fantastic opportunities at heart of Community
Email your CV to
I or call on 02476 432983
Quest 4 Locums Ltd
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For further information, please contact Natlocum@aol.com
MSc in Community Pharmacy
Do you have work or family commitments that make home study attractive?
Queens University Belfast has been delivering postgraduate distance learning
programmes for pharmacists for more than 20 years. These continuing
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than 25 countries around the world.
Our distance learning format allows pharmacists worldwide to obtain
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Credit may be awarded for previous postgraduate courses.
Our next programme will commence in October 2010. For further information
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Manager, Brian McCaw: Tel: 028 9097 2004
School of Pharmacy, MBC,
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QUB School of Pharmacy: www.qub.ac.uk/pha
The School of Pharmacy at Queen's is ranked as the Number 1 School of Pharmacy
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Contact: Andrew Walker
valuing and selling
over 160 years 4
0121 362 8880 ENGLAND & WALES or
01324 631542 SCOTLAND
Capital gains tax changes are
imminent. Have you considered
selling your pharmacy?
• Free, no obligation valuation service
• Professional guidance and management
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Call today for a confidential discussion regarding the sale of your business
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the legal prescription
Cost effective specialist legal advice
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We can assist with buying, selling, merging
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Hilary D'Cruz or Jas Singh
01543 466 660
WE ARE URGENTLY SEEKING
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WITH TURNOVERS OF £500,000 PER ANNUM,
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ANYWHERE IN THE COUNTRY
CONTACT DENIS O'LEARY
on 01206 323808 or Mob 07920 476222
E mail denis.olear v @pharmacybusinesstransfer. co.uk
HUTCHINGS PHARMACY SALES
THINKING OF SELLING THIS YEAR?
If you are planning to sell your pharmacy
you should be preparing for it now.
Call us today for a no obligation confidential discussion:
We can provide:-
An up to date appraisal of the market
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W\ A comprehensive list of information and
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jvj Tips on how to achieve TOP price
We look forward to receiving your call
"We are the only NPA
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Hutchings Consultants Ltd
29.05.10 Chemist Dm ,1 31
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Masfico is moving
We are pleased to announce that Mashco is moving to a large,
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operating there by June. .
Our new address is 17 Colonial Way, Watford, WD24 4PT.
:b and email address details remain the same.
www.mashco.com * email: email@example.com
1 - .* ,
Chemist+Druggist remains the clear leader
in influencing stock decisions*
*linda Jones Associates Industry Survey 2009
Have you received your free listing?
larmacy design and shopfitting
t: 0845 450 5904
Let employers come to you
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THOUSANDS OF RETAIL PHARMACISTS
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Call us NOW to discuss how we can help you?
Phone Anne Hutchings on: 01494 722 224
The Leading Tax Consultants
for Retail Pharmacists.
53-55 Woodside Road,
Hutchings & Co.
in partnership with
Siptirrngbo i \ ' sngo nop mow
forr fthe 201 0-1 i pire-reg
Springboard is a pre-registration programme offered by
Medway School of Pharmacy in partnership with C + D.
Springboard equips pre-registration students with the skills
and confidence to ensure a smooth transition from pharmacy
graduate to practicing pharmacist.
The pringhoHn pre-registration training programme consists
of eight study days facilitated and delivered by staff from C+D
and Medway School of Pharmacy covering a wide variety of
topics, enabling students to meet the appropriate competencies
in the RPSCB's student handbook.
Springboard is unique in that by the end of the course the
students will have also completed an accredited medicines
use review training programme, the C+D Counterpart
pharmacy assistant course, the Practice Certificate in Pharmacy
Management course, as well as receiving a subscription to an
online practice exam question website.
Springboard also includes a training day for the
The cost of Springboard is from £1,200 (+ VAT) per student.
For more information phone 0207 921 8413
or email firstname.lastname@example.org
ARE YOU A
modiplus provides the following
compliance services at a fixed price:
" Preparation of annual accounts
8 Preparation of tax returns
" Filing accounts and returns with the HMRC
and Companies House
:: Ensuring your accounts and tax returns are filed on time
:: Registering you with the HMRC for
8 Help you with the purchase of pharmacy
• : Ad hoc email and telephone advice
with our friendly staff etc.
I am very happy to have an accountant who
is a locum specialist. By going into company, I have
saved tax and the savings I made in the first year
more than covers the accountant's fees. ^ y
JNJ LOCUM LTD, LONDON
For more information or for a
FREE consultation please call Sangeeta
on 020 7383 3200 "
P™ modi pluso
1 ADDING VALUE
MEMBER OF SILVER LEVENE GROUP
THE ONLY REGULATED FIRM OF ACCOUNTANTS
AND TAX ADVISERS SPECIALISING IN RETAIL PHARMACIES
Got a story for Postscript?
Rowlands celebrates 200 years of service
To mark Rowlands' 200th anniversary, Postscript takes a look back at how the
chain has grown over the past two centuries and what lies in store for the future
It all began 200 years ago, during the reign of King
George III (the mad one), when the first Rowlands
pharmacy branch opened in High Street,
Wrexham, North Wales.
The business branches out and a second store is
opened in Ruabon, near Wrexham.
One hundred years after the first store opened,
and the Rowlands family has become a local
institution. Leonard Rowland was the Mayor of
Wrexham throughout the First World War and
was knighted in 1920, while Mary Rowland was
awarded an OBE.
^AkC-H b, 1911.
"WHEN GEORGE THE 1 *
1 THIRD WAS KING." j
, h[V d ,d „. *. rlS"^ trtU comes FIRST.
M0ML -.-----'-'r^«- CLEANLINESS.
Always a hard-working group, a total of 25,562
prescriptions were dispensed in January and
February 1931 alone .
Rowland Cole, several times great-grandson of the
founder Edward Rowland, joins the company. He is
pictured with his son, right, during an interview for
the Daily Telegraph in 1989.
Local paper the Daily Post features the
pharmacies, quoting Langshaw Rowland as saying:
"I opened the shop at 8.30am to 9.00pm in the
week and to midnight on Saturday.
"Prior to that it was 6am opening in the summer
and 7am in the winter."
By now the chain has 245 employees and 14
branches. The company also diversifies, with
Humphrey Rowland starting the multiple's
wholesale business in Wrexham.
Rowlands has 505 community pharmacy
branches located across the UK. May also sees
Rowlands open its first nursing and mobility shop,
offering a more specialist range of equipment
to complement the products stocked by its
is your pharmacy celebrating a milestone this
v/.? i Posts* ripl I now what you're up to
A word from the MD
"Rowlands is proud
to be celebrating
200 years of
services in the heart
around the UK,"
"Our success can
be attributed to our
loyal, hard working and dedicated staff who
know our customers and understand local
health needs. In the last two years alone we
have celebrated many long service awards with
our branch staff and seen 14 teams and
individuals gain awards at national pharmacy
events, in honour of their achievements.
"Moving into 2010, we will build on our
existing solid foundations of patient care and
maintain our community focus. We will
continue to invest in staff development and
peer-led learning and utilise our simple, but
effective, team approach to empower our
staff to use their skills and talents to serve
"We already have an online staff forum and
in June this year we will have our first staff
conference, attended by two staff from each
of our 505 pharmacies. We will use the
opportunity to provide feedback from different
areas, share ideas and support future plans for
"I believe this approach will allow us to
sustain and develop a successful pharmacy
business. The team approach has worked for
the last 200 years so why change a highly
From top: an article about Rowlands in The Leader
newspaper from 1931; an advert proudly declares the
number of prescriptions dispensed by Rowlands in
January and February of the same year; Rowland Cole
and his son get down to business with The Daily
Telegraph in 1989; while Rowland the Owl prove a big
hit in the community in 2010
34 Chemist+Drueeisi 29.05.10
PHARMACY ASSISTANT COURSE
Counterpart is an accredited training course for medicines
counter assistants. Staff will work through a series of 1 k
learning modules covering different therapy areas. The
learning modules can be shared with colleagues making the
course the most economical on the market. A telephone
marking system means staff will get instant results when
they complete each module.
Written by a team of experienced community pharmacists,
Counterpart will equip your assistants with the knowledge
required to recommend and sell medicines safely and
lb register your staff, call 0207 921 8425 or vfs1t
FROM THE NUMBER 1 SELLING PHARMACY PAIN BRAN
(excl Private Lab
in 1 1 ! 1 1 1
For short term treatment of acute moder
not relieved by paracetamol, ibuprofen or aspirin alone
Can cause addiction. Use for 3 days only.
Product Information: Solpadeine Max Soluble Tablets. Presentation: Paracetamol 500 mg, Codeine Phosphate Hemihydrate 12.8 mg and Caffeine 30 mg. Uses: Short term treatmen
of acute moderate pain not relieved by paracetamol, ibuprofen or aspirin alone. Dosage and administration: Dissolve in water before taking. Adults and children, 12 years and over: Two!
tablets up to four times daily. Not more than 8 tablets in 24 hours. Children under 12 years: Not recommended. Do not take for more than 3 days without consulting a doctor.
Contraindications: Known hypersensitivity to ingredients. Precautions: Can cause addiction. Use for 3 days only. Renal or hepatic impairment, non-cirrhotic alcoholic liver disease. Sain
restricted diet. Sufferers from persistent headache and withdrawal symptoms should consult a doctor. Interactions: Warfarin or other coumarin anticoagulants, domperidone, metoclopramide,
colestyramine, monoamine-oxidase inhibitors, mexiletene. Pregnancy/lactation: Do not use without medical advice. Side effects: Paracetamol: rarely, hypersensitivity including skin rash;
very rarely, reports of blood dyscrasias (not necessarily causally related). Codeine: constipation, nausea, vomiting, vertigo, difficulty with micturation, dry mouth, rashes, urticaria, dizziness,
drowsiness, restlessness and irritability. Legal category: P. Product licence number: 00071/0234. Product licence holder: GlaxoSmithKline Consumer Healthcare, Brentford, TW8 9GS,
U.K. Package quantity and RSP: 16s £3.49, 32s £5.89. Date of last revision: January 2010. Solpadeine is a registered trade mark of the GlaxoSmithKline group of companies.
' Source: Neilsen: Total Chemists MAT Value & Unit Sales (11.12.09)